A review of urinary fistulae in a university teaching hospital
Wadhawan, S.; Wacha, D.S.
International Journal of Gynaecology and Obstetrics the Official Organ of the International Federation of Gynaecology and Obstetrics 21(5): 381-385
1983
ISSN/ISBN: 0020-7292 PMID: 6141096 DOI: 10.1016/0020-7292(83)90005-xDocument Number: 425805
A retrospective study of 163 cases of urinary fistulae in the Department of Obstetrics and Gynecology of the University Teaching Hospital, Lusaka, Zambia, from 1974-1981 were analyzed. 82 were operated; 61 cases had sufficiently complete records for this study, and 44 operations are reported. 25.9% were teenagers, 26.2% were ages 20-30; 37.6% were primigravidas. 88.5% were obstetric fistula, the rest were associated with hysterectomy or cervical cancer. 59.2% were juxtaurethral, most common in obstructed labor. Mid-vaginal fistulae, easier to repair, were next common (20.8%). A rare case of vesico-uterine fistula after cesarean section, associated with cyclic hematuria but no urine leakage, was noted. 82 were operated, with an overall cure rate of 59.1%. Types of surgeries were transvaginal flapsplitting in 29 with 68.9% success, Martius procedure in 3 with 66.7% success, and transvesical approach in 9 with 44.4% success. There was also 1 suprapubic urethral reconstruction, 1 flapsplitting with reconstruction of the urethra, and 1 urinary diversion.