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[Vesicovaginal fistulas].

A Haferkamp1, N Wagener, S Buse

  • 1Urologische Klinik, Universitätsklinikum, Heidelberg. Axel_Haferkamp@med.uni-heidelberg.de

Der Urologe. Ausg. A
|February 11, 2005
PubMed
Summary

Vesicovaginal fistulas, often caused by childbirth or gynecologic surgery, lead to urine loss. Surgical repair offers an 85% cure rate for women with this condition.

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Area of Science:

  • Urology
  • Gynecology
  • Surgical Repair

Background:

  • Vesicovaginal fistulas are abnormal connections between the bladder and vagina.
  • They commonly result from obstetric trauma in developing regions and gynecologic surgery in developed countries.
  • The primary symptom is urinary incontinence.

Purpose of the Study:

  • To review the causes, clinical presentation, and surgical management of vesicovaginal fistulas.
  • To highlight the key principles for successful surgical repair.
  • To report the efficacy of surgical interventions.

Main Methods:

  • Review of surgical techniques for vesicovaginal fistula repair.
  • Discussion of essential elements for successful surgical outcomes.
  • Analysis of reported cure rates for different surgical approaches.

Main Results:

  • Surgical repair of vesicovaginal fistulas can be achieved through transvaginal, transvesical, or transperitoneal approaches.
  • Successful repair hinges on adequate exposure, mobilization, fistula tract excision, tension-free closure, and interposition flaps when necessary.
  • Approximately 85% of patients achieve cure after a single surgical procedure.

Conclusions:

  • Vesicovaginal fistulas are a significant clinical challenge, particularly in certain demographics.
  • Multiple surgical approaches exist, with success dependent on meticulous surgical technique.
  • Current surgical methods provide a high success rate for fistula repair.

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