Genitourinary fistulas of obstetric origin

Objective: To review the results of management of 42 cases of genitourinary fistulas of obstetric origin.Settings: Department of urology, Nishtar Hospital, Multan. Pakistan.Methods: Forty two cases of genitourinary fistulas (36 vesicovaginal, 2 vesicouterine, one ureterovaginal and 3urethrovaginal) were repaired from 1st December, 1999 to 31st May, 2002). All fistulas were repaired three months or more after formation. Transabdominal 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.Results: Overall success rate for all types of fistula was 85.7% (36 pts).Conclusion: 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.