Management of female genitourinary fistulas: transvesical or transvaginal approach?
OBJECTIVE
We reviewed 25 female genitourinary fistula repairs performed at our institution from 1993 to 1997.


METHODS
Our series comprised 7 primary vesicovaginal, 6 recurrent vesicovaginal, 7 complex, 1 ureterovaginal and 4 urethrovaginal fistulas. Postoperative followup ranged from 8 months to 5 years.


RESULTS
Overall, 92% of the patients were cured (23 of 25). The 2 failures occurred in patients with a history of pelvic malignancy involving adjuvant therapy.


CONCLUSIONS
Complex irradiated vesicovaginal fistulas require staged repairs, often with pedicle flaps. However, primary repair of uncomplicated vesicovaginal fistulas is highly successful. Limited transvesical repair of these fistulas offers reliable success with minimal morbidity and hospital stay comparable to those of the transvaginal approach.
Leng
W W
WW
Department of Obstetrics and Gynecology, University of Texas-Houston Medical School, USA.
Amundsen
C L
CL
McGuire
E J
EJ
D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D013514:Surgical Procedures, Operative / Q000379:methods; D014515:Ureteral Diseases / Q000601:surgery*; D014522:Urethral Diseases / Q000601:surgery*; D001743:Urinary Bladder; D014548:Urinary Fistula / Q000601:surgery*; D014621:Vagina; D014624:Vaginal Fistula / Q000601:surgery*