Abstract
Purpose
To review all cases of genitourinary fistula, their causes, management and outcome.
Materials and methods
A retrospective chart review of all fistula cases referred to the Urogynecology Department, King Fahad Medical City, Riyadh, Saudi Arabia, from January 2005 to December 2011.
Results
Sixteen genitourinary fistula cases were identified; nine (56 %) cases of vesicovaginal fistula, four (25 %) cases of vesicouterine fistula, and three (19 %) cases of vesicocervical fistula. Mean age was 41 (29–61) and mean parity was 7.4 (2–15). Out of the 16 cases, 12 (75 %) had obstetrical surgical complications, of which 8 (50 %) had complications of cesarean sections. Twelve of 15 cases (80 %) were cured after primary surgical repair, 2 (13 %) after secondary repair and 1 after tertiary repair. One case was cured after conservative management.
Conclusion
Most of the genitourinary fistulae were of iatrogenic obstetric causes, mainly cesarean section with none of the cases due to obstructed labor unlike fistulae in developing countries or developed countries fistulae (iatrogenic gynecologic origin).
Similar content being viewed by others
References
Wall LL, Arrowsmith SD, Briggs ND, Browning A, Lassey A (2005) The obstetric vesicovaginal fistula in developing world. Obstet Gynecol Surv 60(7 Suppl 1):S3–S51
Miller EA, Webster GD (2001) Current management of vesicovaginal fistulae. Curr Opin Urol 11(4):417–421
Porcaro AB, Zicari M, Zecchini Antoniolli S et al (2002) Vesicouterine fistulae following cesarean section: report on a case, review and update of the literature. Int Urol Nephrol 34(3):335–344
Keralti MO, Tinor S, Ozturk NT, Ozturk DC (2012) A case with vesicouterine fistula: mini review. Arch Gynecol Obstet 285:667–670
Bettez M, Breault G, Carr L, le Tu M (2011) Early versus delayed repair of vesicouterine fistula. Can Urol Assoc J 5(4):E52–E55
Dudderidge TJ, Haynes SV, Davies AJ, Jarmulowicz M, Al-Akraa MA (2005) Vesicocervical fistula: rare complication of cesarean section demonstrated by magnetic resonance imaging. Urology 65(1):174–745
Singh V, Mandhani PA, Mehrotra S, Sinha RJ (2011) Laparoscopic repair of vesicouterine fistula. A brief report with review of literature. Urol J 8(2):149–152
Kleeman SD, Vassallo B, segal J et al (2002) Vesicocervical fistula following insertion of a modified Mc Donald suture. BJOG 109:1408–1409
Pelosi MA 3rd, Pelosi MA (1996) Vesicouterine fistula: a rare complication of vaginal birth after cesarean section. Obstet Gynecol 87:160–162
Krysiewicz S, Auh YH, Kazam E (1998) Vesicouterine fistula associated with placenta percreta. Urol Radiol 10:213–215
Sultana CJ, Goldburg J, Aizenmam L, Chon JK (2002) Vesicouterine fistula after uterine artery embolization: a case report. Am J Obstet Gynecol 187:1726–1727
Wall LL, Karshima JA, Kirschner C, Arrowsmith SD (2004) The obstetric vesicovaginal fistula: characteristics of 899 patients from, Jos Nigeria. Am J Obstet Gynecol 190(4):1011–1019
Kamil A, Perveen K, Tannir M (2011) Factors associated with caesarean deliveries at Women’s Specialized Hospital King Fahd Medical City, Riyadh. J Egypt Public Health Assoc 86(3–4):73–76
Hassan S, Ba’aqeel (2009) Cesarean delivery rates in Saudi Arabia: a ten-year review. Ann Saudi Med 29(3):179–183
Rahman MS, Gasem T, Al Suleiman SA, Al Jama FE, Burshaid S, Rahman J (2009) Bladder injuries during cesarean section in a university hospital: a 25-year review. Arch Gynecol Obstet 279(3):349–352
Wall LL, Khan F, Adams S (2007) Vesicovaginal fistula formation after cervical cerclage mimicking premature rupture of membranes. Obstet Gynecol 109(2 Pt2):493–494
Ibeanu OA, Chesson RR, Echols KT, Nieves M, Busangu F, Nolan TE (2009) Urinary tract injury during hysterectomy based on universal cystoscopy. Obstet Gynecol 113:6–10
Al-Badr A, Malabary O, Al Jasser A, Zimmerman V (2010) Common genitourinary fistulae at a referral hospital in Saudi Arabia. Pelviperineology 29:110–112
Al-Badr A, Brasha Hadya, Al-Raddadi Rajaa, Noorwali Fatma, Ross Susan (2012) Prevalence of urinary incontinence among Saudi women. Int J Gynecol Obstet 117(2):160–163
Aronson MP, Delancey JOL, Lee RA (1999) Prevention and immediate management of urinary tract injury. (Panel Discussion) female Pelvic medicine and reconstructive Surgery 5(5):282–292
Duong TH, Gellasch TL, Adam RA (2009) Risk factors for the development of vesicovaginal fistula after incidental cystotomy at the time of a benign hysterectomy. Am J Obstet Gynecol 201(5):512.e1–512.e4
Conflict of interest
We declare that we have no conflict of interest.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Perveen, K., Al-Shaikh, G., Al-Moazin, M. et al. Urogenital fistula in a Saudi Arabian referral center. Arch Gynecol Obstet 287, 261–265 (2013). https://doi.org/10.1007/s00404-012-2541-x
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00404-012-2541-x