[Vesicouterine fistulas: an experience of 17 years].
OBJECTIVE
To discuss the diagnostic and the prognostic problems of vesicouterine fistulas (VUF) emphasizing on the therapeutic characteristics that lead to successful treatment.


METHODS
The authors retrieve retrospective series of 16 cases, collected between 1989 and June 2006, and they analyze the clinical, diagnostic and therapeutic aspects.


RESULTS
The patients were young (29-40 years) with an average having three children. Cesarean was the most frequent etiology. The presentation symptoms were hematuria (in five cases), a urinary incontinence through the vagina (in eight cases) and both of them (in three cases). The diagnosis was suspected from the history and confirmed by the additional analyses. The treatment was surgical (excision of the fistulas) in 15 cases with an average follow-up of 2.5 years, the results on the functional aspect were satisfactory hence they were marked by the absence of urinary incontinence as well as the hematuria. On the obstetric aspect, the occurrence of pregnancy was noted in a patient at four years post-VUF repair.


CONCLUSIONS
Vesicouterine fistulas are not very frequent and most often secondary to a cesarean or to consequences of difficult delivery. The treatment is essentially preventive by improving the obstetrical techniques through avoiding the bladder injuries during the cesareans.
Drissi
M
M
Service d'urologie B, CHU Ibn-Sina, Rabat, Maroc. mounirusdoc@yahoo.fr
Karmouni
T
T
Tazi
K
K
El Khader
K
K
Koutani
A
A
Ibn Attya
A
A
Hachimi
M
M
D000328:Adult; D002585:Cesarean Section / Q000009:adverse effects; D005260:Female; D005402:Fistula / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D006417:Hematuria / Q000209:etiology; D006801:Humans; D008875:Middle Aged; D007744:Obstetric Labor Complications; D011247:Pregnancy; D012189:Retrospective Studies; D001747:Urinary Bladder Fistula / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D014549:Urinary Incontinence / Q000209:etiology; D014591:Uterine Diseases / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*