Skip to main content

Fistula: Introduction

  • Chapter
Pelvic Floor Disorders
  • 2318 Accesses

Abstract

The female genital and urinary tracts share a common embryological origin and therefore the potential for intraoperative and postoperative injury should always be taken into consideration when operating on either one. It has been estimated that urinary tract injuries complicate approximately 1% of all gynecologic procedures and cesarean sections [1]. These injuries are usually divided into two categories:

  1. 1.

    acute intraoperative complications such as a bladder, ureter and/or urethra perforation or laceration that are usually identified immediately during the primary surgery

  2. 2.

    late postoperative (chronic) complications such as various kinds of urinary tract fistulae or stenosis, which can occur later on after the operation or even several years after radiotherapy.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 219.00
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Gilmour DT, Dwyer PL, Carey MP. Lower urinary tract injury during gynecologic surgery and its detection by intraoperative cystoscopy. Obstet Gynecol 1999;94:883–889.

    Article  CAS  PubMed  Google Scholar 

  2. Michael P, Aronson MD, Teresa M, Bose MD. Urinary tract injury in pelvic surgery. Clin Obstet Gynecol 2002; 45:428–438.

    Article  Google Scholar 

  3. Second Meeting of the Working Group for the Prevention and Treatment of Obstetrical Fistula, Addis Ababa, Africa; 30 October 2002. New York: United Nations Population Fund, 2003.

    Google Scholar 

  4. Evans DH, Madjar S, Politano VA et al. Interposition flaps in transabdominal fistula repairs: are they really necessary? Urology 2001;57:670–674

    Article  CAS  PubMed  Google Scholar 

  5. Eilber KS, Kavaler E, Rodriguez LV et al. Ten-year experience with transvaginal vesicovaginal fistula repair using tissue interposition. J Urol 2003;169:1033–1036.

    Article  PubMed  Google Scholar 

  6. Bai SW, Huh EH, Jung DJ et al. Urinary tract injuries during pelvic surgery: incidence rates and predisposing factors. Int Urogynecol J 2006;17:360–364.

    Article  Google Scholar 

  7. Kelly J, Winter HR. Reflections on the knowledge base for obstetric fistula. Int J Gynecol Obstet 2007;99:S21–S24

    Article  Google Scholar 

  8. Angioli R, Gomez-Marin O, Cantuaria G, O’Sullivan MJ. Severe perineal lacerations during vaginal delivery: the University of Miami experience. Am J Obstet Gynecol 2000;182:1083–1085.

    Article  CAS  PubMed  Google Scholar 

  9. Browning A, Patel TL. FIGO initiative for the prevention and treatment of vaginal fistula. Int J Gynecol Obstet 2004;86:317–322.

    Article  CAS  Google Scholar 

  10. Lee RA, Symonds RE, Williams TJ. Current status of genitourinary fistula. Obstet Gynecol 1988;72:313–319.

    CAS  PubMed  Google Scholar 

  11. Oh BR, Kwon DD, Park KS et al. Late presentation of ureteral injury after laparoscopic surgery. Obstet Gynecol 2000;95:337–339.

    Article  CAS  PubMed  Google Scholar 

  12. Boronow RC. Repair of the radiation-induced vaginal fistula utilizing the Martius technique. World J Surg 1986;10: 237–248.

    Article  CAS  PubMed  Google Scholar 

  13. Blandy JP, Badenoch DF, Fowler CG et al. Early repair of iatrogenic injury to the ureter or bladder after gynecological surgery. J Urol 1991;146:761–765.

    CAS  PubMed  Google Scholar 

  14. Goodwin WE, Scardino PT. Vesicovaginal and ureterovaginal fistulas: a summary of 25 years of experience. J Urol 1980;123:370–374.

    CAS  PubMed  Google Scholar 

  15. Liapis A, Bakas P, Giannopoulos V, Creatsas G. Ureteral injuries during gynecological surgery. Int Urogynecol J Pelvic Floor Dysfunct 2001;12:391–394.

    Article  CAS  PubMed  Google Scholar 

  16. Sims JM. On the treatment of vesicovaginal fistula. Am J Med Sci 1852;23:59–82.

    Article  Google Scholar 

  17. Mahfouz Bey N. Urinary fistulae in women. J Obstet Gynaecol Br Emp 1930;45:405–424.

    Google Scholar 

  18. Krishnan RG. A review of a series of 100 cases of vesicovaginal fistulae. J Obstet Gynaecol Br Emp 1949;56:22–27.

    CAS  PubMed  Google Scholar 

  19. McConnachie EL. Fistulae of the urinary tract in the female. S Afr Med J 1958;32:524–527.

    CAS  PubMed  Google Scholar 

  20. Bird GC (1967) Obstetric vesico-vaginal and allied fistulae: a report on 70 cases. J Obstet Gynaecol Br Commonw 1967;74:749–752.

    CAS  PubMed  Google Scholar 

  21. Hamlin RH. Reconstruction of the urethra totally destroyed in labour. BMJ 1969;2:147–150.

    Article  CAS  PubMed  Google Scholar 

  22. Arrowsmith SD. The classification of obstetric vesico-vaginal fistulas. A call for an evidence-based approach. Int J Gynecol Obstet 2007;99:S25–S27.

    Article  Google Scholar 

  23. Goh JT. A new classification for female genital tract fistula. Aust N Z J Obstet Gynecol 2004;44:502–504.

    Article  Google Scholar 

  24. Lapitan MC, Rienhardt G. Surgical management of vesicovaginal and/or urethrovaginal fistulae (protocol for a Cochrane Review). Cochrane Database Syst Rev 2009(4):CD003307.

    Google Scholar 

  25. Wall LL, Karshima JA, Kirschner C, Arrowsmith S. The obstetric vesico-vaginal fistula: characteristics of 899 patients from Jos, Nigeria. Am J Obstet Gynecol 2004;90:1011–1623.

    Article  Google Scholar 

  26. Miller S, Lester F, Webster M, Cowan B. Obstetric fistula: a preventable tragedy. J Midwifery Women’s Health 2005; 50:286–294.

    Article  Google Scholar 

  27. Eilber KS, Kavaler E, Rodriguez LV et al. Ten-year experience with transvaginal vesicovaginal fistula repair using tissue interposition. J Urol 2003;69:1033–1036.

    Article  Google Scholar 

  28. Rovner ES. Vesicovaginal and urethrovaginal fistulas. AUA Update Series 2006;25:45–56.

    Google Scholar 

  29. Cohen BL, Gousse AE. Current techniques for vesicovaginal fistula repair: surgical pearls to optimize cure rate. Curr Urol Rep 2007;8:413–418.

    Article  PubMed  Google Scholar 

  30. Blaivas JG, Heritz DM, Romanzi LJ. Early versus late repair of vesicovaginal fistulas: vaginal and abdominal approaches. J Urol 1995;153:1110–1112.

    Article  CAS  PubMed  Google Scholar 

  31. Raz S, Bregg KJ, Nitti VW, Sussman E. Transvaginal repair of vesicovaginal fistula using a peritoneal flap. J Urol 1993;150:56–59.

    CAS  PubMed  Google Scholar 

  32. O’Conor VJ. Transperitoneal transvesical repair of vesicovaginal fistula with omental interposition. AUA Update Series 1991;10:lesson 13.

    Google Scholar 

  33. Melah GS, El-Nafaty AU, Bukar M. Early versus late closure of vesicovaginal fistulas. Int J Gynecol Obstet 2006;93:252–253.

    Article  CAS  Google Scholar 

  34. Stovsky MD, Ignatoff JM, Blum MD et al. Use of electrocoagulation in the treatment of vesicovaginal fistulas. J Urol 1994;152:1443–1444.

    CAS  PubMed  Google Scholar 

  35. Muto G, D’Urso L, Castelli E et al. Cyanoacrylic glue: a minimally invasive nonsurgical first line approach for the treatment of some urinary fistulas. J Urol 2005;174:2239–2243.

    Article  CAS  PubMed  Google Scholar 

  36. Sharma SK, Perry KT, Turk TMT. Endoscopic injection of fibrin glue for the treatment of urinary-tract pathology. J Endourol 2005;19:419–423.

    Article  PubMed  Google Scholar 

  37. Cohen BL, Gousse AE. Current techniques for vesicovaginal fistula repair: surgical pearls to optimize cure rate. Curr Urol Rep 2007;8:413–418.

    Article  PubMed  Google Scholar 

  38. O’Conor VJ. Review of experience with vesicovaginal fistula repair. J Urol 1980;123:367–369.

    PubMed  Google Scholar 

  39. Nardos R, Browning E, Member B. Duration of bladder catheterization after surgery for obstetric fistula. Int J Gyn Obstet 2000;103:30–32.

    Article  Google Scholar 

  40. Ojengbede OA, Morhason-Bello IO, Shittu O. One-stage repair for combined fistulas: myth or reality? Int J Gynecol Obstet 2007;99:S90–S93.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2010 Springer-Verlag Italia

About this chapter

Cite this chapter

Rechberger, T. (2010). Fistula: Introduction. In: Santoro, G.A., Wieczorek, A.P., Bartram, C.I. (eds) Pelvic Floor Disorders. Springer, Milano. https://doi.org/10.1007/978-88-470-1542-5_84

Download citation

  • DOI: https://doi.org/10.1007/978-88-470-1542-5_84

  • Publisher Name: Springer, Milano

  • Print ISBN: 978-88-470-1541-8

  • Online ISBN: 978-88-470-1542-5

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics