AI Article Synopsis

  • - The study analyzed 116 patients with vesicovaginal fistula from 2004 to 2016, focusing on demographics, causes, repair methods, and potential ureteric injuries associated with the condition.
  • - Only 3.4% of the patients showed ureteric injuries, with varying complications such as ureteric obstruction and ureterovaginal fistulas. All injuries were treated alongside the repair of the fistula.
  • - The findings suggest that ureteric injury is less common than previously thought, affecting less than 5% of patients, and successful management of these injuries is crucial for abdominal repair procedures.

Article Abstract

Objectives: To report a large series of vesicovaginal fistula, and to assess the incidence of ureteric injury in association with vesicovaginal fistula.

Methods: We retrospectively reviewed a prospective database of patients with vesicovaginal fistula referred to our center between 2004 and 2016. Data on patient demographics, fistula etiology, mode of repair, and any associated ureteric injury and its treatment were noted.

Results: Overall, 116 patients (median age 49 years, range 23-88 years) were referred for management of vesicovaginal fistula during the study period. Four of these patients (3.4%) had associated ureteric injury, one of whom had bilateral injury. Ureteric obstruction alone was noted in two patients, ureterovaginal fistula alone in one patient, and bilateral ureteric obstruction and ureterovaginal fistula in one patient. All ureteric injuries were managed with simultaneous reimplantation into the bladder at the time of vesicovaginal fistula repair. Five patients had post-radiotherapy vesicovaginal fistula, and the remainder were post-surgical. Three patients with post-radiotherapy vesicovaginal fistula proceeded to primary diversion.

Conclusions: Ureteric injury is far less common than previously reported, occurring in <5% of patients presenting with vesicovaginal fistula. It can be successfully managed, and it remains the major indication for abdominal repair of vesicovaginal fistula.

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Source
http://dx.doi.org/10.1111/iju.13965DOI Listing

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