Rafique M
Nishtar Medical College, Multan, Pakistan.
Int Urol Nephrol. 2002;34(4):489-93. doi: 10.1023/a:1025679205541.
To review the results of management of 42 cases of genitourinary fistulas of obstetric origin.
Department of urology, Nishtar Hospital, Multan, Pakistan.
Forty two cases of genitourinary fistulas (36 vesicovaginal, 2 vesicouterine, one ureterovaginal and 3 urethrovaginal) were repaired from 1st December, 1999 to 31st May, 2002). All fistulas were repaired three months or more after formation. Trans-abdominal and vaginal repair of vesicovaginal fistulas was undertaken in 29 and 7 patients respectively. Two patients had trans-abdominal closure of vesicouterine fistulas. Ureteroneocystostomy with antireflux mechanism was performed for uretereovaginal fistula. For three urethrovaginal fistulas transvaginal layered repair was carried out.
Overall success rate for all types of fistula was 85.7% (36 pts).
The surgical treatment of genitourinary fistulas will depend upon the type, size and location of fistula. Acceptable results can be achieved by adhering to the surgical principles of fistula repair i.e. optimal tissue conditions, adequate exposure and tension free closure.
回顾42例产科源性泌尿生殖瘘的治疗结果。
巴基斯坦木尔坦尼什塔尔医院泌尿外科。
1999年12月1日至2002年5月31日期间，对42例泌尿生殖瘘（36例膀胱阴道瘘、2例膀胱子宫瘘、1例输尿管阴道瘘和3例尿道阴道瘘）进行了修复。所有瘘均在形成后三个月或更长时间进行修复。29例膀胱阴道瘘患者采用经腹修复，7例采用经阴道修复。2例患者经腹闭合膀胱子宫瘘。输尿管阴道瘘采用带抗反流机制的输尿管膀胱再植术。3例尿道阴道瘘采用经阴道分层修复。
所有类型瘘的总体成功率为85.7%（36例）。
泌尿生殖瘘的手术治疗将取决于瘘的类型、大小和位置。遵循瘘修复的手术原则，即最佳组织条件、充分暴露和无张力闭合，可取得满意的结果。
