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Iatrogenic urogenital fistulae
V C Onuora1, S al-Mohalhal, A M Youssef
1Department of Urology, Riyadh Central Hospital, Saudi Arabia.
British Journal of Urology
|February 1, 1993
Summary
Iatrogenic urogenital fistulae, often from gynecological surgery, can cause significant symptoms. Preliminary diversion followed by delayed reconstruction offers a valuable management option for uretero-vaginal fistulae.
Area of Science:
- Urology
- Gynecology
- Surgical Complications
Background:
- Iatrogenic urogenital fistulae are a recognized complication of obstetric and gynecological surgery.
- These fistulae can lead to significant patient morbidity, including urinary leakage, menouria, and perineal dermatitis.
- The majority of cases in this series resulted from treatment for benign conditions.
Purpose of the Study:
- To review the management and outcomes of iatrogenic urogenital fistulae treated between 1985 and 1989.
- To evaluate the efficacy of preliminary diversion and delayed reconstruction for uretero-vaginal fistulae.
Main Methods:
- Retrospective review of 19 patients with iatrogenic urogenital fistulae.
- Surgical reconstruction techniques included the Boari-Ockerblad flap, uretero-neocystostomy, and other methods.
- Preliminary percutaneous nephrostomy was utilized for all uretero-vaginal fistulae.
Main Results:
- Twelve patients underwent successful reconstruction with excellent outcomes.
- The Boari-Ockerblad flap and uretero-neocystostomy were among the effective reconstructive techniques used.
- Fistulae complicating cancer surgery were infrequent in this cohort.
Conclusions:
- Iatrogenic urogenital fistulae predominantly arise from benign gynecological procedures.
- Preliminary diversion followed by delayed reconstruction is a highly effective strategy for managing uretero-vaginal fistulae.
- Successful surgical reconstruction can significantly improve patient outcomes.