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Clinical Profile, Surgical Approach and Outcome of Complicated Genital Fistulae in Urban Population of a Developing Nation

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Abstract

Objectives

To study aetiology and management of complicated genital fistulae and to evaluate the outcome of the treatment.

Methods

This observational study enrolled patients with complicated genital fistulae from September 2008 to August 2018 at Sant Parmanand Hospital, Delhi. Patients underwent a reparative surgery or ureteric stenting after a detailed preoperative workup. Patients were followed up for the assessment of outcomes.

Results

A total of 16 patients were recruited: Ten (62.5%) patients had fistulae secondary to gynaecological surgeries (seven laparoscopic and three abdominal hysterectomies) and six (37.5%) patients had obstetric fistulae. At a mean follow-up of 5.8 years among obstetric fistulae and 7.3 years among post-operative fistulae, 100% success rate was maintained with the first attempt of reparative surgery or ureteric stenting. There were no major complications. Two patients had recurrent urinary tract infections, and one patient had transient urinary incontinence for 4 weeks.

Conclusion

The study demonstrates that complicated genital fistulae occur more commonly secondary to gynaecological surgeries as compared to obstetric complications in a contemporary cohort from a metropolitan city. A 100% success rate of reparative surgery could be achieved with a transperitoneal approach. Good outcome in ureteric fistulae can be achieved with conservative approach, after proper case selection.

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Author information

Authors and Affiliations

  1. Department of Obstetrics and Gynaecology, NDMC Medical College and Hindu Rao Hospital, Delhi, India

    Preeti Yadav

  2. Department of Obstetrics and Gynaecology, Sant Parmanand Hospital, Delhi, India

    Sonal Bathla, Poonam Singh & Nirmala Agarwal

  3. Department of Urology, Sant Parmanand Hospital, Delhi, India

    T. C. Sharma

  4. Department of Obstetrics and Gynaecology, Sitaram Bharatia Hospital, Delhi, India

    Priti Arora Dhamija

Authors
  1. Preeti Yadav
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  2. Sonal Bathla
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  3. T. C. Sharma
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  4. Priti Arora Dhamija
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  5. Poonam Singh
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  6. Nirmala Agarwal
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Corresponding author

Correspondence to Preeti Yadav.

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All the co-authors declare that there is no conflict of interest.

Human Participants

It is an observational study involving human participants.

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Informed consent was taken from each participant.

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Dr. Preeti Yadav- Assistant Professor, Department of Obstetrics and Gynaecology, NDMC medical college and Hindu Rao Hospital; Dr. Sonal Bathla- Senior Consultant, Department of Obstetrics and Gynaecology, Sant Parmanand Hospital, Dr. T. C. Sharma- Senior Consultant, Department of Urology, Sant Parmanand Hospital; Dr. Priti Arora Dhamija- Consultant, Department of Obstetrics and Gynaecology, Sitaram Bharatia Hospital; Dr. Poonam Singh- Formerly Junior Consultant, Department of Obstetrics and Gynaecology, Sant Parmanand Hospital; Dr. Nirmala Agarwal- Head Of Department, Department of Obstetrics and gynaecology.

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Yadav, P., Bathla, S., Sharma, T.C. et al. Clinical Profile, Surgical Approach and Outcome of Complicated Genital Fistulae in Urban Population of a Developing Nation. J Obstet Gynecol India 70, 163–168 (2020). https://doi.org/10.1007/s13224-019-01291-7

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  • DOI: https://doi.org/10.1007/s13224-019-01291-7

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