Hemant Kamal
Urogynaecological fistulas are a result of devastating injury in which there is an abnormal opening between a woman’s urinary bladder, urethra or ureter with genital tract (Uterus or Vagina) , resulting in urinary incontinence . There are 2 varieties of fistulas . One is caused by obstetric complications , while second one is due to gynaecology procedure. Fistula can also be divided as simple fistula i.e. non-fibrotic tissue & easy to access and complex fistula like fibrotic tissue, loss of tissue, large fistula, urethral involvement, retracted bladder & previous failed surger. Materials & Methods 10 cases of urogynaecological fistulas were treated at our department during period from August 2014 to June 2016. These were 3 patients of simple VVF ,3 patients of complex VVF , 2 patients of uterovesical fistulas and 2 patients of urethrovaginal fistulas. Cystoscopy was essential in all patients to confirm the diagnosis, size & number of fistulas, position and relation with ureteric orifices. Pelvic examination was done in all patients just after cystoscopy to look for vaginal opening of fistula, condition of vaginal mucosa etc . Determining all these points, fistula repair was done either transabdominally or transvaginally. Result All patients except malignant VVF were operated in department of Urology PGIMS Rohtak . Out of 9 patients who were operated, 2 repairs were failed . Conclusion Only 2 case failed in post-operative period. . In 1 patient of complex VVF , there was recurrence noted during 8th post-operative day of hospital stay and in other patient of urethrovaginal fistula, there was meatal stenosis with obliteration which subsequently got corrected after re surgery. We concluded that repair should be meticulous, water tight, suture margins should not be overlapping
