[Actinic bladder-rectal-vaginal fistulas]

Combined fistulas between urinary bladder, rectum and vagina are one of the most serious complications after radiation therapy of genital carcinoma in female patients. The prognosis quo ad restitutionem is poor also at the present time. In our material of 25 cases the restoration of complete faecal and urinary continence was achieved in only 5 patients, however with a loss of the ability of sexual intercourse. In 5 cases an ileum conduit combined with an anus praeter was the definitive solution and in 4 further cases the hygienic situation was improved by colpocleisis and vesico-rectal anastomosis, respectively. In the other patients only a palliative and symptomatical therapy was possible because of poor condition, advanced age and unfavourable local situation.