MANAGEMENT OF UNREPAIRABLE URINARY VAGINAL FISTULAS IN A DEVELOPING-COUNTRY

Thirty-eight out of 44 patients with unrepairable urinary and rectal v aginal fistulae obtained good to excellent results from diverting the urine by uretero-colic anastomosis. The patients who hitherto were reg arded as social outcasts became integrated into society once again. In testinal conduits are generally not employed for urinary diversion, be cause of the social dislike for colostomies and ileostomies, coupled w ith the lack of availability of the necessary external appliances, in Nigeria. In spite of the good results recorded, it is felt that urinar y diversion by uretero-colic anastomosis for vesico-vaginal fistulae s hould be regarded as the last resort; there are well-known adverse com plications from the operation, coupled with psychological trauma to th e patients because of their inability to micturate in the normal fashi on.