EXPERIENCE WITH THE IMMEDIATE TREATMENT OF IATROGENIC BLADDER INJURIES AND THE REPAIR OF COMPLEX VESICUVAGINAL FISTULAS BY THE TRANSVESICALAPPROACH

We describe our experience in treating 16 established cases of vesicov aginal fistulae in non-irradiated bladders which followed obstetric an d gynecological procedures. The fistulae, most of which were large and complex, were successfully repaired surgically after two to three mon ths intervals, using the O'Connor transvesical technique. The advantag es of late correction using the transvesical approach in such cases ar e discussed. Thirteen additional cases of accidental bladder injuries during obstetric and gynecological procedures are presented. These inj uries were successfully treated by immediate primary sutures. Our expe rience shows that bladder injuries mainly occur in women who had previ ously had a Cesarean section.