VESICOUTERINE FISTULA - AN ANALYSIS OF 24 CASES FROM POLAND

Objective: This study was undertaken to evaluate what clinical events or situations are currently associated with the occurrence of vesicout erine fistula. Method: A retrospective investigation was carried out o n 24 patients treated in a tertiary referral center during a 12-year p eriod. Clinical data were collected from the patients directly, the me dical records, urographic and/or cystoscopic findings before repair an d intraoperative findings at repair. Results: All fistulas were iatrog enic, and 21 (87.5%) occurred following cesarean section or cesarean h ysterectomy. Bladder injury occurred two times more often after repeat operations than after the primary. The proportion of repeat cesarean section resulting in a fistula was significantly increased (58.3% vs. 29.6%, P<0.013) when compared to that previously reported. Conclusions : Cesarean sections are currently the single major risk factor associa ted with the occurrence of vesicouterine fistulas. Repeat procedures i ncrease the risk of bladder injury and resultant fistulas. (C) 1997 In ternational Journal of Gynecology and Obstetrics.