RSS-Feed abonnieren
DOI: 10.1055/s-2003-39036
Genitourinary Fistulae
Publikationsverlauf
Publikationsdatum:
07. Mai 2003 (online)
![](https://www.thieme-connect.de/media/ccrs/200301/lookinside/thumbnails/10.1055-s-2003-39036-1.jpg)
ABSTRACT
Genitourinary tract fistulae are primarily iatrogenic and result from a wide range of pelvic surgical procedures. The addition of radiation therapy increases the likelihood of the fistula development and complicates corrective management. Each type of fistula has signs and symptoms that suggest the diagnosis. However, the evaluation combines radiological and endourological tests to properly assess the fistula before progressing to definitive management. Uterovaginal fistulae are the most amenable to a trial of conservative therapy. The management of isolated ureterovaginal fistulae has been altered with the development of endourologic tools such as indwelling ureteral stents. The vast majority of vesicovaginal fistulae require surgical management because of the unremitting vaginal leakage of urine. Determination of the specific approach is dependent on the fistula etiology and any coexistent pathology. The suspicion of a ureteroiliac fistula warrants aggressive investigation and intervention. The vascular component of the fistula must be managed on the basis of the state of the lower extremity vasculature.
KEYWORDS
Vesicovaginal - ureterovaginal - ureterovesical - ureteroiliac - fistula
REFERENCES
- 1 Zacharin R F. A history of obstetric vesicovaginal fistula. Aust NZ J Surg . 2000; 70 851-854
- 2 Sims J M. On the treatment of vesicovaginal fistula. Am J Med Sci . 1852; 23 59-82
- 3 Longo L D. On the treatment of vesico-vaginal fistula. Am J Obstet Gynecol . 1995; 172 1936-1937
- 4 Hedlund H, Lindstedt E. Urovaginal fistulas: 20 years of experience with 45 cases. J Urol . 1987; 137 926-928
- 5 Goodwin W E, Scardino P T. Vesicovaginal and ureterovaginal fistulas: a summary of 25 years of experience. J Urol . 1980; 123 370-374
- 6 Raz S. Editorial comment. J Urol . 1995; 153 1112-1113
- 7 Symmonds R E. Incontinence: vesical and urethral fistulas. Obstet Gynecol . 1984; 27 499-514
- 8 Lee R A, Symmonds R E, Williams T J. Current status of genitourinary fistula. Obstet Gynecol . 1988; 72 313-319
- 9 Tancer M L. Observations on prevention and management of vesicovaginal fistula after total hysterectomy. Surg Gynecol Obstet . 1992; 175 501-506
- 10 Harkki-Siren P, Sjoberg J, Tiitinen A. Urinary tract injuries after hysterectomy. Obstet Gynecol . 1998; 92 113-118
- 11 Tancer M L. The post-total hysterectomy (vault) vesicovaginal fistula. J Urol . 1980; 123 839-840
- 12 Rackley R R, Appell R A. Vesicovaginal fistula: current approach. American Urological Association Update Series . 1998; 21 161-168
- 13 Hilton P. Urodynamic findings in patients with urogenital fistulae. Br J Urol . 1998; 81 539-542
- 14 Stovsky M D, Ignatoff J M, Blum M D, Nanninga J B, O'Conor V J, Kursh E D. Use of electrocoagulation in the treatment of vesicovaginal fistulas. J Urol . 1994; 152 1443-1444
- 15 Dogra P N, Nabi G. Laser welding of vesicovaginal fistula. Int Urogynecol J . 2001; 12 69-70
- 16 Morita T, Tokue A. Successful endoscopic closure of radiation induced vesicovaginal fistula with fibrin glue and bovine collagen. J Urol . 1999; 162 1689-1690
- 17 Kanaoka Y, Hirai K, Ishiko O, Ogita S. Vesicovaginal fistula treated with fibrin glue. Int J Gynecol Obstetr . 2001; 73 147-149
- 18 Miklos J R, Sobolewski C, Lucente V. Laparoscopic management of recurrent vesicovaginal fistula. Int Urogynecol J . 1999; 10 116-117
- 19 McKay H A. Vesicovaginal and vesicocutaneous fistulas: transurethral suture cystorrhaphy as a new closure technique. J Urol . 1997; 156 1513-1516
- 20 Blaivas J G, Heritz D M, Romanzi L J. Early versus late repair of vesicovaginal fistulas: vaginal and abdominal approaches. J Urol . 1995; 153 1110-1113
- 21 Blandy J P, Badenoch D F, Fowler C G, Jenkins B J, Thomas N WM. Early repair of iatrogenic injury to the ureter or bladder after gynecological surgery. J Urol . 1991; 146 761-765
- 22 Dupont M C, Raz S. Vaginal approach to vesicovaginal fistula repair. Urology . 1996; 48 7-9
- 23 Raz S, Bregg K J, Nitti V W, Sussman E. Transvaginal repair of vesicovaginal fistula using a peritoneal flap. J Urol . 1993; 150 56-59
- 24 Hurley L J, Previte S R. Vaginal pedicled flap for closure of vesicovaginal fistula. Urology . 2000; 56 856iv-856vi
- 25 Patil U, Waterhouse K, Laungan G. Management of 18 difficult vesico-vaginal and urethro-vaginal fistulas with modified Ingelmann-Sundberg and Martius operations. J Urol . 1980; 123 653-656
- 26 Elkins T E, Delancy J OL, McGuire E J. The use of modified Martius graft as an adjunctive technique in vesicovaginal and vesicorectal fistula repair. Obstet Gynecol . 1980; 75 727-733
- 27 Wang Y, Hadley H R. The use of rotated vascularized pedicle flaps for complex transvaginal procedures. J Urol . 1993; 149 590-592
- 28 Eilber K S, Rosenblum N, Rodriguez L V, Raz S. 10-year experience of transvaginal vesicovaginal fistula repair utilizing a peritoneal flap (abstract 814). J Urol . 2002; 167(suppl) 202
- 29 O'Conor Jr J V. Review of experience with vesicovaginal fistula repair. J Urol . 1980; 123 367-369
- 30 Evans D H, Madjar S, Politano V A, Bejany D E, Lynne C M, Gousse A E. Interposition flaps in transabdominal vesicovaginal fistula repairs: are they really necessary?. Urology . 2001; 57 670-674
- 31 Carr L K, Webster G D. Abdominal repair of vesicovaginal fistula. Urology . 1996; 48 10-11
- 32 Nesrallah L J, Miguel S, Gittes R F. The O'Conor technique: the gold standard for supratrigonal vesicovaginal fistula repair. J Urol . 1999; 161 566-568
- 33 Ostad M, Uzzo R G, Coleman J, Young G PH. Use of a free bladder mucosal graft for simple repair of vesicovaginal fistula. Urology . 1998; 52 123-126
- 34 Mondet F, Chartier-Kastler E J, Conort P, Bitker M O, Chatelain C, Richard F. Anatomic and functional results of transperitoneal-transvesical vesicovaginal fistula repair. Urology . 2001; 58 882-886
- 35 Akman R Y, Sargin S, Özdemir G, Yaziciog˘lu A, Çetin S. Vesicovaginal and ureterovaginal fistulas: a review of 39 cases. Int Urol Nephrol . 1999; 31 321-326
- 36 Selzman A A, Spirnak J P, Kursh E D. The changing management of ureterovaginal fistulas. J Urol . 1995; 153 626-628
- 37 Jozwik M, Jozwik M, Lotocki W. Vesicouterine fistula-an analysis of 24 cases from Poland. Int J Gynaecol Obstet . 1997; 57 169-172
- 38 Yip S K, Leung T Y. Vesicouterine fistula: an updated review. Int Urogynecol J Pelvic Floor Dysfunct . 1998; 9 252-256
- 39 Memon M A, Zieg D A, Neal P M. Vesicouterine fistula twenty years following brachytherapy for cervical cancer. Scand J Urol Nephrol . 1998; 32 293-295
- 40 Youssef A F. `Menouria' following lower segment cesarean section. A syndrome. Am J Obstet Gynecol . 1957; 73 759-767
- 41 Kalis E G, Kokotas N S. Post-ceasarean vesicouterine fistula. Int Urol Nephrol . 1980; 12 123-127
- 42 Ramamurthy S, Vijayan P, Rajendran S. Sonographic diagnosis of a uterovesical fistula. J Ultrasound Med . 2002; 12 817-819
- 43 Murphy J M, Lee G, Sharma S D, Doble A, Lomas D J. Vesicouterine fistula: MRI diagnosis. Eur Radiol . 1999; 9 1876-1878
- 44 Kennedy C M, Peleg D, Syrop C, Nygaard I. Antenatal diagnosis of vesicouterine fistula. Obstet Gynecol . 1999; 94 808-809
- 45 Jozwik M, Jozwik M. Spontaneous closure of vesicouterine fistula: account for effective hormonal treatment. Urol Int . 1999; 62 183-187
- 46 Miklos J R. Laparoscopic treatment of vesicouterine fistula. J Am Assoc Gynecol Laparosc . 1999; 6 339-341
- 47 Hemal A K, Kumar R, Nabi G. Post-cesarean cervicovesical fistula: technique of laparoscopic repair. J Urol . 2001; 165 1167-1168
- 48 Toolin E, Pollack H M, McLean G K, Banner M P, Wein A J. Ureteroarterial fistula: a case report. J Urol . 1984; 132 553-554
- 49 Taylor W N, Reinhart H L. Mycotic aneurysm of common iliac artery with rupture into the right ureter: report of a case. J Urol . 1939; 42 21
- 50 Davidson O W, Smith R P. Uretero-arterial fistula: report of a case. J Urol . 1939; 24 257
- 51 Hamer H G. Fatal ureteral hemorrhage due to erosion into the iliac artery: report of a case during indwelling catheter drainage for pyelitis of pregnancy. Trans Am Assoc Genitourin Surg . 1939; 32 177-178
- 52 Finney R P. Experience with new double J ureteral stent. J Urol . 1978; 120 678-681
- 53 Batter S J, McGovern F J, Cambria R P. Ureteroarterial fistula: case report and review of the literature. Urol . 1996; 48 481-489
- 54 Vandersteen D R, Saxon R R, Fuchs E, Keller F S, Taylor Jr M L, Barry J M. Diagnosis and management of ureteroiliac artery fistula: Value of provocative arteriography followed by common iliac artery embolization and extraanatomic arterial bypass grafting. J Urol . 1997; 158 754-758
- 55 Gibbons M, O'Donnell S, Lukens M, Meglin A, Costabile R A. Treatment of a ureteroiliac artery fistula with an intraluminal endovascular graft. J Urol . 1998; 159 2083-2084
- 56 Puppo P, Perachino M, Riccoiotti G, Zinicola N, Patone P E. Urteroarterial fistula: a case report. . 1992; 184 863-864
- 57 Grime P D, Wilmsfurst C C, Clyne C A. Spontaneous iliac artery aneurysm-ureteric fistula. Eur J Vasc Surg . 1989; 3 455-456