title: Complex obstetric fistulae--two case reports.
abstract: Two cases of complex obstetric fistulae are reported. Poor assessment and mismanagement of labour were revealed. The resulting fistulae were vesico-urethro-rectovaginal and vesico-cervico-vaginal. Plastic repair using a modified Martius graft was used in case 1. Considering the young age of the patient, transplantation of the ureters into the rectum or colon was deemed undesirable. The patient's endurance over a period of ten years, with seventeen attempts at repair ultimately was rewarded by achieving both vesical and rectal continence. Repair using the transvaginal route was successful at the first attempt in case 2.
authors.affiliation: Department of Obstetrics and Gynaecology, Faculty of Medical Sciences, University of the West Indies, Queen Elizabeth Hospital, Barbados, West Indies.
authors.forename: J
authors.initials: J
authors.lastname: Ashmore
authors.forename: F
authors.initials: F
authors.lastname: Attapattu
mesh_terms: D000328:Adult; D036861:Delivery, Obstetric / Q000009:adverse effects; D005260:Female; D006801:Humans; D011247:Pregnancy; D019651:Plastic Surgery Procedures / Q000379:methods*; D012006:Rectovaginal Fistula / Q000209:etiology / Q000601:surgery*; D012086:Reoperation; D014719:Vesicovaginal Fistula / Q000209:etiology / Q000601:surgery*