title: Ureterovaginal fistula--etiological factors and outcome.
abstract: OBJECTIVE
  To assess the etiological factors and the outcome of ureterovaginal fistula in an urban setting.
  
  
  METHODS
  The observational study was conducted at the Armed Forces Institute of Urology, Military Hospital, Rawalpindi, from January 2009 to January 2011. All the patients of uretero-vaginal fistula at the centre were included on the basis of non-probability purposive sampling. The etiology, clinical presentation and the investigative procedures were recorded. The operative modality contemplated was noted and post-operative results were evaluated. The data was entered in a structured proforma and analysed for descriptive statistics using SPSS version 14.0.
  
  
  RESULTS
  Seventeen cases of ureterovaginal fistula were recorded. Amongst these 10 (58.8%) were post-hysterectomy, while 7 (41.1%) cases post-caesarean section. The emergency procedures performed by the residents/junior registrars contributed 12 (70.2%) of the cases. All these patients were treated surgically; 14 (82.3%) were managed with ureteroneocystostomy, 2 (11.7%) required Boari Flap reconstruction, and in psoas hitch was performed in 1 (5.8%) case. The time of intervention was 4 - 12 weeks (9.76 +/- 2.223). Post-operatively, only 1 (5.8%) case had superficial wound infection and 1 (5.8%) urinary tract infection. All the patients remained dry with a follow-up period of 3 - 24 months (mean 12.24 +/- 6.879).
  
  
  CONCLUSIONS
  Ureterovaginal fistula is one of the complications of emergency procedures, especially in the hands of inexperienced surgeons. Prompt diagnosis and surgical intervention produce excellent results. Intervention can be done safely as early as 4 weeks after the initiation of the condition.
authors.affiliation: Department of Urology, Armed Forces Institute of Urology, Military Hospital, Rawalpindi. badar_murtaza@yahoo.com
authors.forename: Badar
authors.initials: B
authors.lastname: Murtaza
authors.forename: Arshad
authors.initials: A
authors.lastname: Mahmood
authors.forename: Waqar Azim
authors.initials: WA
authors.lastname: Niaz
authors.forename: Muhammad
authors.initials: M
authors.lastname: Akmal
authors.forename: Hussain
authors.initials: H
authors.lastname: Ahmad
authors.forename: Saira
authors.initials: S
authors.lastname: Saeed
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008875:Middle Aged; D012307:Risk Factors; D015607:Stents; D016896:Treatment Outcome; D014515:Ureteral Diseases / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D014548:Urinary Fistula / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D014624:Vaginal Fistula / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery