Management of Female Genitourinary Fistulas: Transvesical or Transvaginal Approach?

No AccessJournal of UrologyClinical Urology: Original Articles1 Dec 1998MANAGEMENT OF FEMALE GENITOURINARY FISTULAS: TRANSVESICAL OR TRANSVAGINAL APPROACH? WENDY W. LENG, CINDY L. AMUNDSEN, and EDWARD J. McGUIRE WENDY W. LENGWENDY W. LENG , CINDY L. AMUNDSENCINDY L. AMUNDSEN , and EDWARD J. McGUIREEDWARD J. McGUIRE View All Author Informationhttps://doi.org/10.1016/S0022-5347(01)62223-7AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We reviewed 25 female genitourinary fistula repairs performed at our institution from 1993 to 1997. Materials and Methods: Our series comprised 7 primary vesicovaginal, 6 recurrent vesicovaginal, 7 complex, 1 ureterovaginal and 4 urethrovaginal fistulas. Postoperative followup ranged from 8 months to 5 years. Results: Overall, 92% of the patients were cured (23 of 25). The 2 failures occurred in patients with a history of pelvic malignancy involving adjuvant therapy. Conclusions: Complex irradiated vesicovaginal fistulas require staged repairs, often with pedicle flaps. However, primary repair of uncomplicated vesicovaginal fistulas is highly successful. Limited transvesical repair of these fistulas offers reliable success with minimal morbidity and hospital stay comparable to those of the transvaginal approach. References 1 : Vesicovaginal and ureterovaginal fistulas: a summary of 25 years of experience. J. Urol.1980; 123: 370. Link, Google Scholar 2 : Current status of genitourinary fistula. Obst. Gynec.1988; 72: 313. Google Scholar 3 : Simple transvesical repair of vesicovaginal fistulas. J. Urol.1979; 122: 604. Link, Google Scholar 4 : Vesicovaginal fistula repair: a simple suprapubic transvesical approach. Int. Urol. Nephrol.1988; 20: 265. Google Scholar 5 : New surgical approach for treatment of complex vesicovaginal fistulas. J. 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