UROGENITAL FISTULA IN FEMALES – A FOUR YEARS EXPERIENCE
Urogenital Fistula in Females
Keywords:Interposition flap, Ureteric reimplantation Urinary leakage, Vesicovaginal fistula
Objective: To review the aetiology, surgery and outcomes of women with urogenital fistula over a period of four years.
Study Design: Observational study/ case series.
Place and Duration of Study: This study was conducted at the Department of Urology, Armed Forces Institute of Urology Rawalpindi and Department of Gynaecology& Obstetrics, Military Hospital Rawalpindi from Jan 2009 to Jan 2013.
Material and Methods: This was a prospective study from tertiary urology & gynecology units. The females included were confirmed cases of urogenital fistula. A total of 113 cases were selected by non-probability purposive sampling. The pattern of urogenital fistula, operative modality, complications, and urinary symptoms, in particular the absence of urinary leakage (primary outcome) were documented. The data was analysed by SPSS 21.
Results: One hundred and thirteen cases of urogenital fistula were included in this study. Vesicovaginal fistula was seen in 69.9%, 25.7% were ureterovaginal fistula, 2.7% vesicouterine fistula and 0.88% each urethrovaginal fistula and combined fistula. The vesicovaginal fistula was secondary to prolonged obstructed labour in 59.4% with iatrogenic cause in 36.7%. However the total obstetric aetiology was 81.0%, in cases of vesicovaginal fistula. All the other types of urogenital fistula were iatrogenic/ post-surgical. The operative treatment was performed in 97.3% of cases with 99.0% showing absence of urinary leakage at 8 weeks post-operatively.
Conclusion: Vesicovaginal fistula is the most common urogenital fistula. The obstructed labour has remained the commonest cause but emergency operative procedures are on the arise . The operative treatment of urogenital fistula has satisfactory results.