[Vesico-vaginal fistula: report of 1050 cases].
The authors reports their experience of a large series of 1050 cases of vesico-vaginal fistulas recorded during 30 years and analyse their epidemiological, anatomo-clinical, and therapeutic aspects. Patients could be classified as a function of site of fistula into 3 types, according to the Benchekroun's classification: type I ureto-vaginal fistula (30%); type II cervico-vaginal fistula (22%); type III vesico-vaginal fistula (48%). Etiology was mainly obstetrical (93%). An associated lesion was detected in 10.4% of cases (uterine, ureteral and rectal). Treatment was only performed after a minimal period of three months with the following results in obstetrical vesico-vaginal fistulas. Type I fistula, using a low approach and requiring urethral refection in 100 cases, showed good results in only 60% of cases. Type II fistulae, usually treated through a low approach (80%), were treated with 80% good results. Type III fistula, were nearly always corrected (98%) after two procedures. The overall results are good in 80% of cases. The failures concerned in majority the complex vesico-vaginal fistulas type I, are treated by urinary diversion (51 Coffey, 5 Bricker) and since 1975, 73 continent ileocecal or ileal bladders using Benchekrouns' technique.
Benchekroun
A
A
Service d'urologie A, centre hospitalier universitaire Ibn Sina, Rabat, Maroc.
el Alj
H A
HA
el Sayegh
H
H
Lachkar
A
A
Nouini
Y
Y
Benslimane
L
L
Belahnech
Z
Z
Marzouk
M
M
Faik
M
M
D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000379:methods*; D006801:Humans; D015994:Incidence; D008875:Middle Aged; D016896:Treatment Outcome; D001747:Urinary Bladder Fistula / Q000453:epidemiology / Q000473:pathology / Q000601:surgery*; D013520:Urologic Surgical Procedures / Q000379:methods*; D014624:Vaginal Fistula / Q000453:epidemiology / Q000473:pathology / Q000601:surgery*
Les fistules vésico-vaginales: à propos de 1050 cas.