Clinical Observation on Urinary-Vaginal Fistulas

Lee, Seung Ho; Kim, Kyu Hwan

Abstract

Urinary-vaginal fistulas are usually the result of local injury. The common causes are gynecologic and obstetric trauma. During the last 10 years at Han-Il Hospital, 14 patients have been treated by urologists for fistulas between the vagina and the urinary tract. There were 5 uretero-vaginal and 9 vesico-vaginal fistulas. The author analyzed these 14 patients clinically and the results were summerized as follows: 1. The causative injuries of 14 urinary-vaginal fistulas were total abdominal hysterectomies (8 cases), radical hysterectomies (2 cases), Cesarean sections (2 cases), chemical cauterization (one case) and birth trauma (one case). 2. Surgical repairs were tried in eight of 9 vesico-vaginal fistulas and two of 5 uretero-vaginal fistulas. One vesico-vaginal fistula was repaired successfully with transvaginal approach and five (71.4%) of 7 vesico-vaginal fistulas were repaired successfully with transvesical approaches. Two cases of 7 transvesical approaches were failed because of inadequate resection of the surrounding tissue, wound infection and poor catheter drainage. Two uretero-vaginal fistulas were repaired successfully with Boari flap procedure. 3. Ureteral catheterization was tried in three of 5 uretero-vaginal fistulas and two of them were treated successfully with this method.