Vesico-vaginal fistula: report of 1050 cases

• Published in: Annales d'urologie 2003-08, Vol.37 (4), p.194
• Main Authors: Benchekroun, A, el Alj, H A, el Sayegh, H, Lachkar, A, Nouini, Y, Benslimane, L, Belahnech, Z, Marzouk, M, Faik, M
• Format: Article
• Language: fre
• Subjects: Adolescent; Adult; Aged; Female; Gynecologic Surgical Procedures - methods; Humans; Incidence; Middle Aged; Treatment Outcome; Urinary Bladder Fistula - epidemiology; Urinary Bladder Fistula - pathology; Urinary Bladder Fistula - surgery; Urologic Surgical Procedures - methods; Vaginal Fistula - epidemiology; Vaginal Fistula - pathology; Vaginal Fistula - surgery
• ISSN: 0003-4401

The authors reports their experience of a large series of 1050 cases of vesico-vaginal fistulas recorded during 30 years and analyse their epidemiological, anatomo-clinical, and therapeutic aspects. Patients could be classified as a function of site of fistula into 3 types, according to the Benchekroun's classification: type I ureto-vaginal fistula (30%); type II cervico-vaginal fistula (22%); type III vesico-vaginal fistula (48%). Etiology was mainly obstetrical (93%). An associated lesion was detected in 10.4% of cases (uterine, ureteral and rectal). Treatment was only performed after a minimal period of three months with the following results in obstetrical vesico-vaginal fistulas. Type I fistula, using a low approach and requiring urethral refection in 100 cases, showed good results in only 60% of cases. Type II fistulae, usually treated through a low approach (80%), were treated with 80% good results. Type III fistula, were nearly always corrected (98%) after two procedures. The overall results are good in 80% of cases. The failures concerned in majority the complex vesico-vaginal fistulas type I, are treated by urinary diversion (51 Coffey, 5 Bricker) and since 1975, 73 continent ileocecal or ileal bladders using Benchekrouns' technique.