Genitourinary / Fecal Fistulae: Etiology, Types and Surgical Outcomes

Proceedings Pub Date : 2024-01-31 DOI:10.47489/szmc.v38i1.443

Nayyer Sultana, Tayyaba Majeed, Rana Mohammad Iqbal, Tahseen Haider Kazmi, Mirza Zeeshan Sikandar

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Abstract

Introduction: Genitourinary/ fecal fistula is an abnormal communication between the genital tract and either the urinary tract or the gastrointestinal tract. Among genitourinary fistulae, most common is the vesicovaginal followed by ureterovaginal fistula. Aims & Objectives: The aim of our study is to determine various causes and types of genitourinary/fecal fistulae and their surgical outcome in our setting. Place and Duration of Study: A descriptive, retrospective cross-sectional study was conducted at Central Park Teaching Hospital Hospital, Department of Obstetrics and Gynaecology from December 2013-December 2021. Material & Methods: Total of 77 patients presented with various types of genitourinary/fecal fistulae during the study period. All details as demographic characteristics, type and cause of fistula, route of repair and surgical outcome were taken on a standardized proforma. All data was entered and analyzed in SPSS version 26 for statistical analysis.p-value of less than 0.05 was regarded as significant. Results: In this study, the age range was from 22 to 62 years with mean age 38.38 + 10.67 years. Mean duration of fistula was computed as 45.47 + 71.31 months with the range of 1 month to 27 years (324 months). Average fistula size was 1.14 + 0.96 cm with the range of 0.25 cm to 3 centimeters. The obstetric causes of fistulae accounted 44% (n=34) while iatrogenic causes were seen in 56% (n=43) of patients. The most common type of fistula was VVF with 53 (69%) patients followed by uretero-vaginal fistula with 08 (10.0%). The least common type of fistula was urethro-vaginal with only 01 (1%) case of 22 years, 05 (7%) patients had RVF and 08 (10%) had vesico-uterine and vesico-cervical fistulae. the overall success rate is 88.3%. Conclusion: The iatrogenic causes of genitourinary/fecal fistulae are more prevalent than obstetric causes. The successful outcome of fistula repair depends on number of previous attempts of repair and outcome of repair worsen with each number of previous attempts.

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泌尿生殖系统/大便瘘：病因、类型和手术结果

简介泌尿生殖道/粪便瘘是生殖道与泌尿道或胃肠道之间的异常沟通。在泌尿生殖道瘘中，最常见的是膀胱阴道瘘，其次是输尿管阴道瘘：我们的研究旨在确定泌尿生殖道/大便瘘的各种病因、类型及其手术治疗效果：2013年12月至2021年12月，在中央公园教学医院妇产科开展了一项描述性、回顾性横断面研究：在研究期间，共有 77 名患者患有各种类型的泌尿生殖系统/大便瘘。所有详细信息，包括人口统计学特征、瘘管类型和原因、修补途径和手术结果，均记录在标准化的表格中。所有数据均输入 SPSS 26 版进行统计分析：本研究中，患者的年龄范围为 22 至 62 岁，平均年龄为 38.38 + 10.67 岁。平均瘘管持续时间为 45.47 + 71.31 个月，范围为 1 个月至 27 年（324 个月）。瘘管平均大小为 1.14 + 0.96 厘米，范围在 0.25 厘米至 3 厘米之间。产科原因导致的瘘管占44%（34人），而先天性原因导致的瘘管占56%（43人）。最常见的瘘管类型是输尿管阴道瘘，占 53 例（69%），其次是输尿管阴道瘘，占 08 例（10.0%）。最不常见的瘘管类型是尿道阴道瘘，22 岁的患者中仅有 01 例（1%），05 例（7%）患者患有 RVF，08 例（10%）患者患有膀胱子宫瘘和膀胱宫颈瘘，总成功率为 88.3%：结论：泌尿生殖道/大便瘘的先天性原因比产科原因更常见。瘘管修补术的成功率取决于之前尝试修补的次数，修补术的成功率随着尝试次数的增加而降低。

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