[Vesicovaginal fistula. Apropos of 600 cases].
A personal series of 600 cases of vesicovaginal fistula is reviewed. Patients could be classified as a function of site of fistula into 3 groups: I. urethrovaginal fistula (31%); II. cervicovaginal fistula (22%); III. vesicovaginal fistula (46%). Etiology was mainly obstetrical (94%), as was multiparity (69%). An associated lesion was detected in 11% of cases (uterine, ureteral and rectal). Surgery was performed after a minimum period of 3 months with the following results. Type I fistulae, using a low approach and requiring urethral refection, showed good results in only 53% of cases. Type II fistulae, usually treated through a low approach (80%), were relieved in 80% of cases, with the reservation that reinforcement of bladder neck was often necessary. Type III fistulae, treated by a high (60%) or low (40%) approach were nearly always corrected (98%). In 2 cases of destroyed urethra unable to benefit from urethral plastic surgery, bladder repositioning with continent cystostomy was satisfactory. 72 cases with irrecuperable destroyed bladder received definitive high diversion: 34 Coffey, 5 Bricker, and since 1975, 33 continent ileocecal bladders using Benchekrouns' technique.
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D005260:Female; D006801:Humans; D008722:Methods; D008875:Middle Aged; D012189:Retrospective Studies; D014719:Vesicovaginal Fistula / Q000145:classification / Q000473:pathology / Q000601:surgery*
Les fistules vésico-vaginales. A propos de 600 cas.