Main Article Content
Abstract
Highlights:
- Vesicovaginal fistula is the most common urogenital fistula.
- The transvaginal approach is preferred in treating urogenital fistula.
Abstract:
A fistula is an extra-anatomical channel between two or more hollow organs, or between an organ and the body surface. WHO estimated there were two million patients with untreated urogenital fistula, with 130,000 new cases every year. The ideal approach for urogenital fistula depends on surgeon preference and individual clinical characteristics. Accordingly, we aimed to determine the profile of patients with a urogenital fistula at a tertiary hospital of Dr. Soetomo General Academic Hospital in Surabaya, Indonesia, from 2015 to 2021. A retrospective study with a descriptive design was carried out by medical records data retrieval of patients with urogenital fistula. It included age, etiology, anatomical location, surgical management, and recurrence rate. The study population consisted of 55 patients. The majority of the patients were among the 41-50 y.o. age groups (41.17%), while the least were in the <20 years group (1.96%). History of obstructed labor was the most common etiology (70.59%). Fistulas in the study population were also associated with a history of trauma (15.68%) and malignancy (11.76%). The vesicovaginal fistula was the most common type of fistula (88.23%). Other types found include urethrovaginal, ureterovaginal, rectovesical, rectovaginal, and vesicocolon fistulas. The transvaginal approach was preferred in almost all study populations. A total of two cases of vesicovaginal fistula recurred (3.39%). In general, patients with urogenital fistula are prevalent in the 4th decade age group, with the most common etiology being a history of obstructed labor. Transvaginal surgery is the treatment of choice with good results and low recurrence rates.
Keywords
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References
- Abrams P, de Ridder D, Devries C, et al (2012). An international consultation on vesicovaginal fistula co-sponsored by SIU (Société Internationale d'Urologie) ICUD (International Consultation on Urological Diseases) obstetric fistula in the developing world. Société Internationale d'Urologi, Montréal.
- Birge O, Ozbey E, Guzel O, et al (2016). The relationship between urogenital fistula and female genital mutilation. J. Turgur Ozal Med. Cent. 23, 293–296.
- Bodner-Adler B, Hanzal E, Pablik E, et al (2017). Management of vesicovaginal fistulas (VVFs) in women following benign gynecologic surgery: a systematic review and meta-analysis. PLoS One 12, 1–21.
- Danso K, Martey J, Wall L, et al (1996). The epidemiology of genitourinary fistulae in Kumasi, Ghana, 1977–1992. Int. Urogynecol. J. 7, 117–120.
- Djusad S, Sonia A, Natanael A (2016). Characteristics of patients with obstetric and gynecologic fistula in Jakarta. Indones. J. Obstet. Gynecol. 4, 212–217.
- Eilber K, Kavaler E, Rodriguez L, et al (2003). Ten-year experience with transvaginal vesicovaginal fistula repair using tissue interposition. J. Urol. 169, 1033–1036.
- Ghoniem G, Warda H (2014). The management of genitourinary fistula in the third millennium. Arab J. Urol. 12, 97–105.
- Hadzi-Djokie J, Pejcic T, Stamenkovic V, et al (2015). Buccal mucosal graft interposition in the treatment of recurrent vesicovaginal fistula: A report on two cases. Taiwan. J. Obstet. Gynecol. 54, 773–775.
- Harkki-Siren P, Sjuberg J, Tiitinen A (1998). Urinary tract injuries after hysterectomy. Obstet. Gynecol. 92, 113–118.
- Harzif A, Maidarti M, Ginanjar I, et al (2021). Vesicouterine fistula presenting with cyclical haematuria mimicking bladder endometriosis: A case report. Int. J. Surg. Case Rep. 80, 1–3.
- Hess D (2004). Retrospective studies and chart reviews. Respir. Care 49, 1171–1174.
- Hillary C, Osman N, Hilton P, et al (2016). The aetiology, treatment, and outcome of urogenital fistulae managed in well- and low-resourced countries: A systematic review. Eur. Urol. 70, 478–492.
- Hilton P (2016). Trends in the aetiology of urogenital fistula: a case of ‘retrogressive evolution'? Int. Urogynecol. J. 27, 831–837.
- Lo T, Chua S, Wijaya T, et al (2019). Clinical relevance and treatment outcomes of vesicovaginal fistula (VVF) after obstetric and gynecologic surgery. Taiwan. J. Obstet. Gynecol. 58, 111–116.
- Malik MA, Sohail M, Malik MT, et al (2018). Changing trends in the etiology and management of vesicovaginal fistula. Int. J. Urol. 25, 25–29.
- Matsuyama A, Kato K, Sai H, et al (2022). Transvaginal repair of a rectovaginal fistula caused by transvaginal mesh prolapse surgery. IJU Case Reports 5, 255–258.
- Medlen H, Barbier H (2022). Vesicovaginal fistula. StatPearls Publishing, Florida.
- Milani R, Cola A, Frigerio M, et al (2018). Repair of a vesicouterine fistula following cesarean section. Int. Urogynecol. J. 29, 309–311.
- Mocumbi S, Hanson C, Högberg U, et al (2017). Obstetric fistulae in southern Mozambique: Incidence, obstetric characteristics, and treatment. Reprod. Health 14, 1–10.
- Pradhan H, Dangal G, Karki A, et al (2020). Clinical profile of urogenital fistula in Kathmandu model hospital. J. Nepal Health Res. Counc. 18, 210–213.
- Purkait B, Mehrotra S, Sinha R, et al (2017). Long-term outcome of laparoscopic vesicouterine fistula repair: Experience from a tertiary referral center. Turkish J. Urol. 43, 512–516.
- Saeed S, Nawaz N, Murtaza B, et al (2016). Urogenital fistula in females. Pakistan Armed Forces Med. J. 66, 361–366.
- Stamatakos M, Sargedi C, Stasinous T, et al (2014). Vesicovaginal fistula: Diagnosis and management. Indian J. Surg. 76, 131–136.
- Taher T, Zulfikar Z, Wahyudi I, et al (2013). Vesico-vaginal fistula: Experience of 11 years. Indones. J. Urol. 20, 5–10.
- Talla P, Ekotomati M, Brünisholz Y, et al (2017). Consider the risk of vesicouterine fistula in the event of intermittent fluid vaginal discharge after a cesarean section. Front. Surg. 4, 1–4.
- Tasnim N, Bangash K, Amin O, et al (2020). Rising trends in iatrogenic urogenital fistula: A new challenge. Int. J. Gynecol. Obstet. 148, 33–36.
- Wall L (2006). Obstetric vesicovaginal fistula as an international public health problem. Lancet 368, 1201–1209.
- Widarta D, Ardian M, Laksana C, et al (2015). Deteksi dini risiko ibu hamil dengan kartu skor Poedji Rochjati dan pencegahan faktor empat terlambat. Maj. Obstet. Ginekol. 23, 28–32.
References
Abrams P, de Ridder D, Devries C, et al (2012). An international consultation on vesicovaginal fistula co-sponsored by SIU (Société Internationale d'Urologie) ICUD (International Consultation on Urological Diseases) obstetric fistula in the developing world. Société Internationale d'Urologi, Montréal.
Birge O, Ozbey E, Guzel O, et al (2016). The relationship between urogenital fistula and female genital mutilation. J. Turgur Ozal Med. Cent. 23, 293–296.
Bodner-Adler B, Hanzal E, Pablik E, et al (2017). Management of vesicovaginal fistulas (VVFs) in women following benign gynecologic surgery: a systematic review and meta-analysis. PLoS One 12, 1–21.
Danso K, Martey J, Wall L, et al (1996). The epidemiology of genitourinary fistulae in Kumasi, Ghana, 1977–1992. Int. Urogynecol. J. 7, 117–120.
Djusad S, Sonia A, Natanael A (2016). Characteristics of patients with obstetric and gynecologic fistula in Jakarta. Indones. J. Obstet. Gynecol. 4, 212–217.
Eilber K, Kavaler E, Rodriguez L, et al (2003). Ten-year experience with transvaginal vesicovaginal fistula repair using tissue interposition. J. Urol. 169, 1033–1036.
Ghoniem G, Warda H (2014). The management of genitourinary fistula in the third millennium. Arab J. Urol. 12, 97–105.
Hadzi-Djokie J, Pejcic T, Stamenkovic V, et al (2015). Buccal mucosal graft interposition in the treatment of recurrent vesicovaginal fistula: A report on two cases. Taiwan. J. Obstet. Gynecol. 54, 773–775.
Harkki-Siren P, Sjuberg J, Tiitinen A (1998). Urinary tract injuries after hysterectomy. Obstet. Gynecol. 92, 113–118.
Harzif A, Maidarti M, Ginanjar I, et al (2021). Vesicouterine fistula presenting with cyclical haematuria mimicking bladder endometriosis: A case report. Int. J. Surg. Case Rep. 80, 1–3.
Hess D (2004). Retrospective studies and chart reviews. Respir. Care 49, 1171–1174.
Hillary C, Osman N, Hilton P, et al (2016). The aetiology, treatment, and outcome of urogenital fistulae managed in well- and low-resourced countries: A systematic review. Eur. Urol. 70, 478–492.
Hilton P (2016). Trends in the aetiology of urogenital fistula: a case of ‘retrogressive evolution'? Int. Urogynecol. J. 27, 831–837.
Lo T, Chua S, Wijaya T, et al (2019). Clinical relevance and treatment outcomes of vesicovaginal fistula (VVF) after obstetric and gynecologic surgery. Taiwan. J. Obstet. Gynecol. 58, 111–116.
Malik MA, Sohail M, Malik MT, et al (2018). Changing trends in the etiology and management of vesicovaginal fistula. Int. J. Urol. 25, 25–29.
Matsuyama A, Kato K, Sai H, et al (2022). Transvaginal repair of a rectovaginal fistula caused by transvaginal mesh prolapse surgery. IJU Case Reports 5, 255–258.
Medlen H, Barbier H (2022). Vesicovaginal fistula. StatPearls Publishing, Florida.
Milani R, Cola A, Frigerio M, et al (2018). Repair of a vesicouterine fistula following cesarean section. Int. Urogynecol. J. 29, 309–311.
Mocumbi S, Hanson C, Högberg U, et al (2017). Obstetric fistulae in southern Mozambique: Incidence, obstetric characteristics, and treatment. Reprod. Health 14, 1–10.
Pradhan H, Dangal G, Karki A, et al (2020). Clinical profile of urogenital fistula in Kathmandu model hospital. J. Nepal Health Res. Counc. 18, 210–213.
Purkait B, Mehrotra S, Sinha R, et al (2017). Long-term outcome of laparoscopic vesicouterine fistula repair: Experience from a tertiary referral center. Turkish J. Urol. 43, 512–516.
Saeed S, Nawaz N, Murtaza B, et al (2016). Urogenital fistula in females. Pakistan Armed Forces Med. J. 66, 361–366.
Stamatakos M, Sargedi C, Stasinous T, et al (2014). Vesicovaginal fistula: Diagnosis and management. Indian J. Surg. 76, 131–136.
Taher T, Zulfikar Z, Wahyudi I, et al (2013). Vesico-vaginal fistula: Experience of 11 years. Indones. J. Urol. 20, 5–10.
Talla P, Ekotomati M, Brünisholz Y, et al (2017). Consider the risk of vesicouterine fistula in the event of intermittent fluid vaginal discharge after a cesarean section. Front. Surg. 4, 1–4.
Tasnim N, Bangash K, Amin O, et al (2020). Rising trends in iatrogenic urogenital fistula: A new challenge. Int. J. Gynecol. Obstet. 148, 33–36.
Wall L (2006). Obstetric vesicovaginal fistula as an international public health problem. Lancet 368, 1201–1209.
Widarta D, Ardian M, Laksana C, et al (2015). Deteksi dini risiko ibu hamil dengan kartu skor Poedji Rochjati dan pencegahan faktor empat terlambat. Maj. Obstet. Ginekol. 23, 28–32.