Surgical management of female urinary fistulas

ABSTRACT

Our study included 32 female patients suffering from urinary fistula, were treated at El-Minia University Hospital in a period of 2.5 years. In 9 cases the fistulas were ureterovaginal and were treated transperitoneally by ureteroneocystostomy in 5 cases and Boari's flap in 4 cases with 100% success rate. In 22 patients with vesicovaginal fistulas, vaginal approach by flap splitting and vaginal flap techniques were applied for 8 cases with 50% success. The rest of the cases [14 plus the 4 cases of failed vaginal repair] were corrected successfully by the transabdominal approach using the bladder bisection technique with good dissection and separation of the bladder and vaginal wall and omental flap in complicated cases. One case of vesicouterine fistula also was treated in this study. All patients were continent postoperatively except 3 of them, were suffering from urge incontinence. We concluded that results of fistula repair depending mainly on surgeons clinical experience and individual technique