Genitourinary Reconstruction in Obstetric Fistulas
- 1 August 1994
- journal article
- Published by Ovid Technologies (Wolters Kluwer Health) in Journal of Urology
- Vol. 152 (2 Part 1), 403-406
- https://doi.org/10.1016/s0022-5347(17)32749-0
Abstract
Although most recent literature concerning female urinary tract fistulas has addressed the problem of postoperative and post-irradiation fistula, obstetrical fistula is more common worldwide. A series of fistula repairs predominantly caused by obstructed labor is presented. During a 30-months interval 139 procedures were performed on 98 patients with fistulas at a variety of anatomical locations or on patients with type III urinary incontinence following fistula repair. The fistulas were caused by obstructed labor in 94.9% of the patients. Repair was done vaginally in 110 cases, abdominally in 25 and by a combined approach in 3. Of the patients 81% were dry after 1 procedure and all but 4% were dry after multiple procedures. The subjective observations of moderate to severe vaginal scarring, or severe damage to the urethra or bladder neck were the best predictors of adverse outcome.Keywords
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