title: [Uretero-vaginal fistulas. 45 cases].
abstract: The authors report a series of 45 cases of ureterovaginal fistula (UVF) observed over a 25-year period. The patients had a mean age of 34 years (20 to 50 years). 32 UVF (71%) were secondary to obstetric procedures and operations and 13 UVF (29%) were due to hysterectomy for gynaecological diseases. The clinical features were dominated by urine leak via the vagina with persistent micturition (68.8%) and low back pain (40%). UVF was associated with vesicovaginal fistula in 11 patients and acute renal failure was observed in 4 patients. IVU confirmed the diagnosis in 36 patients (87%) and revealed 23 cases of uretero-hydronephrosis and 4 silent kidneys. Retrograde ureteropyelography, performed in 4 cases, confirmed the diagnosis of UVF. The lesion was situated on the right side in 26 patients and was bilateral in the other 3 patients. The commonest lesion was section (48.8%). Treatment consisted of ureterovesical reimplantation (27 cases), Boari-Küss bladder flap of (3 cases), psoas bladder (5 cases), nephrectomy (2 cases), end-to-end anastomosis (2 cases), appendico-ureteroplasty (2 cases), double J stent (2 cases) and ileoureteroplasty (1 case). The course was favourable in 35 patients (77%).
authors.affiliation: Clinique Urologique A, CHU Ibn Sina, Rabat, Maroc.
authors.forename: A
authors.initials: A
authors.lastname: Benchekroun
authors.forename: A
authors.initials: A
authors.lastname: Lachkar
authors.forename: A
authors.initials: A
authors.lastname: Soumana
authors.forename: M H
authors.initials: MH
authors.lastname: Farih
authors.forename: Z
authors.initials: Z
authors.lastname: Belahnech
authors.forename: M
authors.initials: M
authors.lastname: Marzouk
authors.forename: M
authors.initials: M
authors.lastname: Faik
mesh_terms: D000328:Adult; D036861:Delivery, Obstetric / Q000009:adverse effects; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007044:Hysterectomy / Q000009:adverse effects; D008875:Middle Aged; D009392:Nephrectomy; D012092:Replantation; D013524:Surgical Flaps; D016896:Treatment Outcome; D014515:Ureteral Diseases / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery*; D014548:Urinary Fistula / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery*; D014567:Urography; D014624:Vaginal Fistula / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery*
vernacular_title: Les fistules urétéro-vaginales. A propos de 45 cas.