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The upper urinary system comprises two kidneys and two ureters, which are crucial in filtering blood and forming urine.KidneysLocation and Structure:The kidneys are two bean-shaped organs positioned behind the peritoneum on either side of the spine.Kidneys are between the 12th thoracic (T12) and the 3rd lumbar (L3) vertebrae.The position of the liver causes the right kidney to sit slightly lower than the left.Protective Layers:Each kidney is enveloped in a tough, fibrous membrane called the...
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Genitourinary Fistula: An Indian Perspective.

Vinod Priyadarshi1, Jitendra Pratap Singh1, Malay Kumar Bera1

  • 1Department of Urology, IPGMER and SSKM Hospital, Kolkata, 700 020 India.

Journal of Obstetrics and Gynaecology of India
|June 15, 2016
PubMed
Summary

Genitourinary fistulae, often caused by obstetric trauma, present challenges in diagnosis and management. Surgical repair, particularly via the vaginal route, achieved a high success rate of 94.5% in this study.

Keywords:
FistulaGenitourinaryUreterovaginalVesicocervicalVesicouterine

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Area of Science:

  • Urology
  • Gynecology
  • Surgical Science

Background:

  • Genitourinary fistulae are a significant complication, historically linked to obstetric trauma in developing nations.
  • Improved healthcare has altered the landscape, yet fistulae remain a complex clinical issue.

Purpose of the Study:

  • To analyze the presentation, diagnosis, and management of genitourinary fistulae.
  • To emphasize surgical approaches and review existing literature on fistula treatment.

Main Methods:

  • Retrospective analysis of 41 genitourinary fistula cases treated between 2007 and 2013.
  • Evaluation of etiology, fistula characteristics, clinical presentation, diagnostics, and management outcomes.
  • Literature search conducted using the Medline database.

Main Results:

  • The most common etiology was obstetric trauma (56.09%), followed by iatrogenic causes (39.03%).
  • Vesicovaginal fistulae were most frequent (78.37%), involving the trigone (51.72%).
  • The vaginal approach was successful in 51.35% of cases, with an overall success rate of 94.5% post-repair.

Conclusions:

  • Genitourinary fistula management is challenging, with significant psychosocial impacts.
  • Accurate diagnosis, adherence to surgical principles, and experienced surgical repair are crucial for optimal outcomes.