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Genitourinary Fistula: 5 Years’ Experience of Five Referral Centers in Iran

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Abstract

Introduction and Hypothesis

Genitourinary fistula is a devastating ailment that has an impact on women's physical health, mental health, emotional health, and financial security. The management of genitourinary fistula depends on the type, size, and duration of fistula formation. The purpose of this study is to report the features of genitourinary fistula in Iranian women and our experience in the management of fistula.

Methods

Retrospective chart reviews of 283 patients were performed to determine the cause of the fistula, prior repairs, tissue interposition, and the success rate. The operation was considered successful if the patient did not have any urine leakage during the observation time.

Results

The mean (SD) age of women was 49.51 (19.39; range: 21–70) years, Of these, 137 (52.9%) had a history of previous genitourinary fistula surgery. The average fistula was 1.53 (0.041) cm in size. The median (interquartile range) operation lasted 70 (15) min. The success rate after fistula repair was 91.5%. The typical follow-up period lasted 13.26 (range: 1–88) months. Forty-three (15.2%) patients had a big fistula (>2.5 cm) and 4 patients (1.4%) had a history of pelvic radiation therapy, among other reasons for failure. After a second repair, all patients' initial failures were resolved. There were no significant complications, as classified by Clavien–Dindo class 2 or greater. Additionally, there were no bowel, ureteral, or nerve injuries.

Conclusions

Our patients with genitourinary fistula had a successful outcome following repair techniques, without any significant morbidity or mortality.

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Data Availability

Data are available on request.

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Funding

This study is supported by the research vice chancellor of Tabriz University of Medical Sciences.

Author information

Authors and Affiliations

  1. Department of Urology, Shahid Labbafinejad Medical Center, Urology and Nephrology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran

    Farzaneh Sharifiaghdas

  2. Department of Urology, Iran University of Medical Sciences, Tehran, Iran

    Maryam Emami

  3. Department of Urology, Isfahan University of Medical Sciences, Isfahan, Iran

    Mahtab Zargham

  4. Department of Urology, Shahid Bahonar Hospital, Kerman University of Medical Sciences, Kerman, Iran

    Azar Daneshpajooh

  5. Department of Urology, Tabriz University of Medical Sciences, Tabriz, Iran

    Elham Jahantabi, Soroush Sharifimoghadam & Sakineh Hajebrahimi

  6. Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria

    Hadi Mostafaei

  7. Research Center for Evidence-Based Medicine, Iranian EBM Centre: A JBI Centre of Excellence, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran

    Hanieh Salehi-pourmehr & Sakineh Hajebrahimi

  8. Medical Philosophy and History Research Center, Tabriz University of Medical Sciences, Tabriz, Iran

    Hanieh Salehi-pourmehr & Sakineh Hajebrahimi

  9. Department of Urology, Research Center for Evidence-Based Medicine, Tabriz University of Medical Sciences, Imam Reza Teaching Hospital, Attar-E-Neishabouri Sqr., Tabriz, 51666, Iran

    Sakineh Hajebrahimi

Authors
  1. Farzaneh Sharifiaghdas
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  2. Maryam Emami
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  3. Mahtab Zargham
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  6. Soroush Sharifimoghadam
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  8. Hanieh Salehi-pourmehr
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  9. Sakineh Hajebrahimi
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Contributions

F.S., A.D., M.Z., S.H., M.E.: project development and supervision; F.S., A.D., M.Z., S.H., M.E., E.J., S.S.: data collection, manuscript drafting; H.S., H.M.: data analysis. All authors approved the final version of the manuscript.

Corresponding author

Correspondence to Sakineh Hajebrahimi.

Ethics declarations

Ethics of Approval Statement

The regional ethics committee of Tabriz University of Medical Sciences approved the proposal.

Patient Consent statement

A consent form was signed by all patients before initiation of the study.

Permission to Reproduce Material from Other Sources

Not applicable.

Clinical Trial Registration

Not applicable.

Conflicts of Interest

None.

Additional information

Handling Editor: Rufus Cartwright 

Editor in Chief: Maria A. Bortolini

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Sharifiaghdas, F., Emami, M., Zargham, M. et al. Genitourinary Fistula: 5 Years’ Experience of Five Referral Centers in Iran. Int Urogynecol J 35, 893–900 (2024). https://doi.org/10.1007/s00192-024-05761-z

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  • DOI: https://doi.org/10.1007/s00192-024-05761-z

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