title: Urinary tract changes in obstetric vesico-vaginal fistulae: a report of 216 cases studied by intravenous urography.
abstract: Intravenous urographies carried out routinely on 216 cases of vesico-vaginal fistulae were reviewed. All the patients had suffered from urinary incontinence following obstructed labour for periods varying from immediate post-partum period to as long as 35 years with the majority (48%) presenting in the first year of the disease. One hundred and eleven patients (51-4%) showed no urinary tract abnormality. Calyceal abnormality was graded from 1-5 in ascending order of severity. The most frequent abnormality was Grade 1 (or minimal calyceal blunting) found in 75 (71%) of 105 cases showing lesions. Ten patients had non-functioning kidneys. There was no correlation of severity of calyceal grading with duration of the disease. Other notable changes were hydroureter in 75 (34%), medial deviation of the terminal ureters in 21 (9-7%) and bladder calculi in four. The study reveals a high risk of morbidity to the kidneys in patients with vesico-vaginal fistulae and the predominant role of fibrous itssue in tis genesis is postulated.
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D007670:Kidney Calices / Q000000981:diagnostic imaging; D008875:Middle Aged; D011247:Pregnancy; D011248:Pregnancy Complications / Q000000981:diagnostic imaging*; D013997:Time Factors; D014513:Ureter / Q000000981:diagnostic imaging; D001743:Urinary Bladder / Q000000981:diagnostic imaging; D014549:Urinary Incontinence / Q000209:etiology; D014567:Urography; D014570:Urologic Diseases / Q000000981:diagnostic imaging / Q000209:etiology*; D014719:Vesicovaginal Fistula / Q000150:complications / Q000000981:diagnostic imaging* / Q000209:etiology