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Urinary Fistulas

  • Luciano Adolfo Nuñez Bragayrac
  • David Michael Hatcher
  • René Javier Sotelo Noguera
Chapter

Abstract

Urological fistulas include vesicovaginal, urethrovaginal, ureterovaginal, rectourinary (rectourethral and rectovesical), and vesicouterine fistulas. These are usually secondary to an unrelated medical or surgical treatment. The most common presenting symptom is continuous or intermittent urinary incontinence. Conservative management is usually unsuccessful. The most important step in their management is thorough workup, as occasionally, there is more than one fistula present. The principles of urinary fistula repair include adequate nutrition, elimination of sources of infection, unobstructed urinary drainage, tension-free closure, and interposition of healthy tissue. Open repair is the most common treatment; however, minimally invasive approaches are increasingly being performed, following the principles of open surgery. Robotic management of fistulas has the advantage of increased precision during dissection of fibrotic surfaces and reconstruction.

Keywords

Urinary fistulas Robotic repair Complications Reconstructive urology 

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Copyright information

© Springer International Publishing AG 2018

Authors and Affiliations

  • Luciano Adolfo Nuñez Bragayrac
    • 1
  • David Michael Hatcher
    • 2
  • René Javier Sotelo Noguera
    • 3
  1. 1.Roswell Park Cancer InstituteBuffaloUSA
  2. 2.Keck Medicine of USC, USC Institute of UrologyLos AngelesUSA
  3. 3.USC Institute of Urology, University of Southern CaliforniaLos AngelesUSA

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