2 Cases of Female Lower Urinary Tract Fistula Treated with Gracilis Muscle Flap / 대한비뇨기과학회지

The successful closure of a fistula clearly involves application of spectrum of techniques depending variable factors. There was variety of opinions regarding the timing and optimum surgical technique for repair of fistula. Several muscles and myocutaneous flaps are applicable to a variety of tissue defects. The gracilis muscle is especially useful as adjuncts for wound coverage, vaginal or penile reconstruction and as interpositional tissue for the closure of various fistulas. We experienced two cases of female urinary tract fistula treated with gracilis muscle flap successfully.

Clinical Observation on Urinary Tract Fistula / 대한비뇨기과학회지

24 cases of urinary fistulae which were admitted to The Department of Urology, Chonnam University Hospital, during the period from Sept. 1968 to Aug. 1971 were analyzed clinically. 1. 15 cases of all fistulae were in women and 9 in men. 2. The most common age was from 30~35 years with 50%. 3. The most commonly involved site was bladder with 66% and the most common fistula type was vesicovaginal fistula (40%). 4. The most common etiology of vesicovaginal fistula was obstetrical cause 5. 11 cases (44%) of all fistulas occurred after the operation.

Urinary Tract Fistula / 대한비뇨기과학회지

Ninety-six cases of urinary tract fistulas, which were admitted to Severance Hospital during the period from Jan. , 1960 to Dec. 1969, were analyzed clinically and statistically. They were investigated by comparing with previous papers. 1) The rate of urinary tract fistulas accounted for 2.4 per cent of the total admissions to the Urologic Department and 0.057 per cent of Obstetrics and Gynecologic Department during 10 years. Twenty-eight cases of all fistulas were in men and sixty-eight in women. The age distribution was much the same as that found in previous literature. The most common age was from 20~50 years with 91.7 per cent. 2) The most commonly involved site was the bladder with 64.5 per cent and the most common fistula type was vesicovaginal with 42.6 per cent of those involving bladder. 3) About forty-seven per cent of all fistulas occurred after previous pelvic operation, seventeen per cent due to carcinoma of pelvic organs and thirteen per cent due to abnormal delivery. Chemicals, radiation, infection, trauma, foreign body and stone of the urinary tract were listed frequently as an etiologic factors. 4) The incidence of ureteral injury during radical hysterectomy was variable in the literature, but it accounted for 10 per cent generally. Among the 10 per cent of ureteral injury, ureteral fistulas developed in 20 per cent of our cases, but in 12 per cent of Meig's. 5) There are many surgical approaches to repair urinary tract fistulas according to the surgeon's taste, fistula type, location, size or number, previous attempts and adhesion of surrounding tissues. No two fistulas are exactly alike, and surgical approach to any fistula must be well thought before the time of operation. The operation must be fitted to the fistula, not the fistula to the operation. 6) To repair urinary tract fistula is today a somewhat difficult problem, and the operative failure rate in our 41 cases of vesicovaginal fistula was 34.4 per cent.