ABSTRACT
The authors report a series of three cases of Youssef syndrome observed over a 10 year period. All the fistulas were secondary to cesarian section. The diagnosis was established on clinical findings in one case. The intravenous urography was performed in all the cases and visualised the uterine cavity in one case. In the remaining cases the diagnosis was established by the retrograd cystography. The treatment was surgical for two patients and the third one refused any treatment. With a mean recoil of fifteen months the results judged on the disappearance of the clinic signs were good in the two patients opered. The objective of this study is to analyse the aetiological, diagnosis and therapeutic aspects of this pathology.
Subject(s)
Fistula/etiology , Urinary Bladder Fistula/etiology , Uterine Diseases/etiology , Adult , Cesarean Section/adverse effects , Diagnosis, Differential , Female , Fistula/pathology , Fistula/surgery , Humans , Syndrome , Treatment Outcome , Urinary Bladder Fistula/pathology , Urinary Bladder Fistula/surgery , Uterine Diseases/pathology , Uterine Diseases/surgeryABSTRACT
OBJECTIVE: To specify the clinical and therapeutic peculiarities of complex vesico-vaginal fistulas. MATERIAL AND METHODS: 55 cases of complex vesico-vaginal fistulas are reported. After the clinical diagnostic all the patients had an intravenous excretory urogram. The fistulas were classified according to the Benchekroun classification. RESULTS: The mean age was 34 years (17-70 years). The diagnostic was made clinically in all the patients. Thirteen patients had an abnormal intravenous excretory urogram. The treatment was made by a vaginal way in 45 patients, by an abdominal way in three patients and by a mixed way in two patients. Four patients had an urinary diversion and one refused the treatment. Among the 50 patients whose fistula was treated, 44 (88%) were continent whom 26 (52%) after one operation, 15 (30%) after two operations and three (6%) after three operations. CONCLUSION: The complex vesico-vaginal fistulas as all the vesico-vaginal fistulas are diagnosed clinically. The intravenous excretory urogram is indispensable to search an associated ureteral lesion. The treatment is surgical and usually needs the interposition of a vascularised graft.
Subject(s)
Vesicovaginal Fistula/diagnosis , Adolescent , Adult , Aged , Female , Humans , Middle Aged , Vesicovaginal Fistula/complicationsABSTRACT
Sixteen cases of vesicovaginal fistulae (including 14 urethrovaginal fistulae), were treated vaginally using Martius' procedure. The authors describe the technique for the interposition of a labial fat pad, between the bladder and the vagina. The results are good. Thirteen patients have been cured. In one case a second was necessary using Guittes technique. There was two failures.
