title: Surgical outcome of female genital fistula in Korea.
abstract: This purpose of this study was to establish a new standard for the surgical management of female genital fistula in Korea. From January 1992 to October 2001, 117 patients with female genital fistula who were admitted to the departments of obstetrics and gynecology, urology and general surgery were analyzed. Nine patients with congenital etiologies and 48 patients who were treated conservatively were excluded. The relationships between surgical outcome and the cause of fistula, the location of fistula, and the various surgical methods were analyzed. In spite of appropriate surgical treatment, fistulas due to cervix cancer management had the worst prognosis. In terms of location, fistula recurrence after surgical repair was most common in the bladder fundus and base. The transvaginal and transrectal approaches are suitable for fistulas located in the lower vagina. The transabdominal approach is appropriate for fistulas located in the functional portions such as the bladder and ureter, for fistulas which are difficult to expose surgically by either the vaginal or rectal approach, or in cases with severe adhesions. In cases of cervix cancer, extra care should be taken during surgical expiration or definitive radiotherapy, especially when the areas involved are the bladder fundus and base. The nature of the surgical approach should be decided by the location of the fistula, the functional importance of the area, and the degree of surgical exposure during the corrective procedures.
authors.affiliation: Department of Obstetrics and Gynecology, Yonsei University College of Medicine, C.P.O. Box 8044, Seoul 120-752, Korea. swbai@yumc.yonsei.ac.kr
authors.forename: Sang Wook
authors.initials: SW
authors.lastname: Bai
authors.forename: Sung Hoon
authors.initials: SH
authors.lastname: Kim
authors.forename: Han Sung
authors.initials: HS
authors.lastname: Kwon
authors.forename: Koon Ho
authors.initials: KH
authors.lastname: Rha
authors.forename: Kyung Ah
authors.initials: KA
authors.lastname: Chung
authors.forename: Sei Kwang
authors.initials: SK
authors.lastname: Kim
authors.forename: Ki Hyun
authors.initials: KH
authors.lastname: Park
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D005260:Female; D006801:Humans; D007723:Korea; D008875:Middle Aged; D012006:Rectovaginal Fistula / Q000601:surgery; D016896:Treatment Outcome; D014548:Urinary Fistula / Q000601:surgery; D014624:Vaginal Fistula / Q000601:surgery*; D014719:Vesicovaginal Fistula / Q000601:surgery