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[Ureterovaginal fistulas. A report of 17 cases]
S Bennani1, A Joual, M El Mrini
1Service d'Urologie, Casablanca, Maroc.
Objective:
Our purpose was to study aetiopathogenic, diagnostic and therapeutic aspects of ureterovaginal fistulas.
Study Design:
A retrospective study concerned 17 ureterovaginal fistulas in 16 patients. The main causes were gyneacological and obstetrical procedures. The diagnosis was based on clinical considerations and intravenous pyelography in all cases. Three vesicovaginal fistulas were associated with iatrogenic ureteral lesions. Various therapeutic methods were used: psoas-bladder hitch procedure (11 cases) and Boari-Küss flap (4 cases). In two patients, fistulae healed by drainage after ureterolysis.
Results:
Late radiology showed success of the procedure in 14 patients and persistance of ureteral dilatation in 2 cases treated by Boari-Küss procedure.
Conclusion:
Ureterovaginal fistulae are a relatively frequent complication of pelvic surgery. Psoas-bladder hitch is the procedure of choice in such fistulae cure and prevention is the most efficient treatment.