Urinary fistulae caused by gynaecological therapy seen in one urological unit

37 urinary fistulae caused by gynaecological operations and radiotherapy were analyzed. The original disease was malignant in 24 cases and benign in 13 cases. The cause of the fistula was simple hysterectomy in 11 cases, radical hysterectomy in 5 cases, irradiation for pelvic malignancy and irradiation in 5 cases, vaginal operation in 5 cases, infection in 1 case and difficult labour in 1 case. 14 fistulae were closed transabdominally, 6 fistulae were closed transvaginally and 5 fistulae healed by conservative therapy. It was possible to close 2 of the 5 postradiation complex vesicovaginorectal fistulae. 22 patients left the hospital dry voiding via the urethra. Despite successful closure of the fistula 4 patients remained partially or totally incontinent. Using various forms of urinary and intestinal diversion procedures the social performance and quality of life of the patients unsuitable for functional closure of the fistula could be greatly improved.