title: [Complex vesicovaginal fistula. Report of 55 cases].
abstract: OBJECTIVE
  To specify the clinical and therapeutic peculiarities of complex vesico-vaginal fistulas.
  
  
  METHODS
  55 cases of complex vesico-vaginal fistulas are reported. After the clinical diagnostic all the patients had an intravenous excretory urogram. The fistulas were classified according to the Benchekroun classification.
  
  
  RESULTS
  The mean age was 34 years (17-70 years). The diagnostic was made clinically in all the patients. Thirteen patients had an abnormal intravenous excretory urogram. The treatment was made by a vaginal way in 45 patients, by an abdominal way in three patients and by a mixed way in two patients. Four patients had an urinary diversion and one refused the treatment. Among the 50 patients whose fistula was treated, 44 (88%) were continent whom 26 (52%) after one operation, 15 (30%) after two operations and three (6%) after three operations.
  
  
  CONCLUSIONS
  The complex vesico-vaginal fistulas as all the vesico-vaginal fistulas are diagnosed clinically. The intravenous excretory urogram is indispensable to search an associated ureteral lesion. The treatment is surgical and usually needs the interposition of a vascularised graft.
authors.affiliation: Service d'urologie B, hôpital Avicenne, Rabat, Maroc. tazikarim@yahoo.com
authors.forename: K
authors.initials: K
authors.lastname: Tazi
authors.forename: J
authors.initials: J
authors.lastname: el Fassi
authors.forename: T
authors.initials: T
authors.lastname: Karmouni
authors.forename: A
authors.initials: A
authors.lastname: Koutani
authors.forename: A A
authors.initials: AA
authors.lastname: Ibn Attya
authors.forename: M
authors.initials: M
authors.lastname: Hachimi
authors.forename: A
authors.initials: A
authors.lastname: Lakrissa
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008875:Middle Aged; D014719:Vesicovaginal Fistula / Q000150:complications / Q000175:diagnosis*
vernacular_title: Fistules vésicovaginales complexes. A propos de 55 cas.