Complex vesico-vaginal fistulas. A study of 55 cases

Objective: To specify the clinical and therapeutic peculiarities of complex vesico-vaginal fistulas. Material and methods: 55 cases of complex vesicovaginal fistulas are report ed. After the clinical diagnostic all the patients had an intravenous excre tory urogram. The fistulas were classified according to the Benchekroun cla ssification. Results: The mean age was 34 years (17-70 years). The diagnostic was made c linically in all the patients. Thirteen patients had an abnormal intravenou s excretory urogram. The treatment was made by a vaginal way in 45 patients , by an abdominal way in three patients and by a mixed way in two patients. Four patients had an urinary diversion and one refused the treatment. Amon g the 50 patients whose fistula was treated, 44 (88%) were continent whom 2 6 (52%) after one operation, 15 (30%) after two operations and three (6%) a fter three operations. Conclusion: The complex vesico-vaginal fistulas as all the vesico-vaginal f istulas are diagnosed clinically. The intravenous excretory urogram is indi spensable to search an associated ureteral lesion. The treatment is surgica l and usually needs the interposition of a vascularised graft (C) 2001 Edit ions scientifiques et medicales Elsevier SAS.