RESUMO
Ureterovaginal fistula commonly occurs as a result of complication of pelvic surgeries with gynaecologic surgeries accounting for approximately two thirds. It is one of the most feared complications of pelvic surgery. Objectives: This study aims to determine the aetiological factors, role of ultrasound in the confirmation of dignosis and outcome of surgical repair of ureterovaginal fistula at the National Obstetric Fistula Centre, Katsina (NOFIC). Methods: This was a two-year retrospective review of all cases that underwent surgical repair for ureterovaginal fistula at the National Obstetric Fistula Centre Babbar Ruga, Katsina from 1st Jan, 2016 to 31st Dec, 2017. Result: A total of 27 patients had surgery for ureterovaginal fistula during the study period. However only 25 case notes were eligible for data entry and analysis. The mean age of the patients was 29.88 ± 8.53 with a modal parity of one. Eighty-eight percent presented with history of leakage of urine per vagina following emergency caesarean section, caesarean hysterectomy in 8%, prolonged obstructed labour in 8% and gynaecological hysterectomy in 4%. The onset of leakage varied from 2 to 10 days with a mean duration of onset of 5.64 ± 1.70. In addition to the ureterovaginal fistula, 3 had vesicouterine (VUF) fistula and 1 had vesicocervicovaginal (VCVF) fistula. The fistula was bilateral in 2 of the patients. The fistulae involved the left ureter in 13 patients and the right ureter in 10. Abdominal ultrasound was the main means of confirmation of diagnosis. Abdominal reimplantation of the ureter was the most common (88%) treatment approach. Majority 88% (22/25) were healed and continent at discharge. Conclusion: Emergency caesarean section was found to be commonest aetiological factor and the use of abdominopelvic ultrasound was found to be effective in the confirmation of diagnosis and identifying the affected ureter.