Retrospective study of 213 cases of female urogenital fistulae at the Department of Urology & Transplantation Civil Hospital Quetta, Pakistan.

ABSTRACT

OBJECTIVES: To review our experience in causes, diagnosis and basic principles of surgical treatment of urogenital fistulae. METHODS: A retrospective study of 213 patients with different types of urogenital fistulae were reviewed between October 1995 to October 2008. They were analyzed with regard to age, parity, causal factor, mode of treatment and outcome. Patients were also evaluated at two or three weeks initially, three monthly and later depending upon symptoms. RESULTS: We reviewed our series of female urogenital fistulae treated over a 13 years period. Out of these 213 cases, 133 (62.44%) were Vesico vaginal fistulae, 54 (25.35%) Urethro vaginal fistulae and 26 (12.2%) were Uretero vaginal. Majority of the patients were young in child bearing age between 16 and 30 years of age, although age range was wide i.e., 11 to 50 years. The most common cause of urogenital fistulae were Obstetrical trauma due to obstructed labour in 50 (37.59%) and Gynaecological (hysterectomy 25 (18.79%) and caesarian section in 9 (6.77%). Patients of Uretero vaginal fistulae were mainly due to unrecognized ureteral injuries during Gynaecological procedures (hysterectomy in 17 cases and caesarian section in 5 cases). For repair of vesico vaginal fistulae, Transvaginal route for repair was used in 53 (39.84%) patients, while Trans abdominal route for repair was used in 70 (52.63%) patients. There were 16 (12.03%) failures in Vesico vaginal fistulae with a success rate of 88%. Mean Hospital stay was 15 +/- 3.5 days (range 4-30 days) and a mean follow-up of 8 +/- 3.2 months (range 4 months to 2 years). CONCLUSIONS: In this series, most of the female urogenital fistulae were vesico-vaginal with majority of the women being in the child bearing age. The most common cause was obstetrical trauma.