Approach to Ureterovaginal Fistula: Examining 13 Years of Experience.

Female Pelvic Medicine & Reconstructive Surgery
Yufan Brandon ChenElizabeth R Mueller

Abstract

We describe the management and outcomes of ureterovaginal fistulas over a 13-year period and present a treatment algorithm. We performed a review of ureterovaginal fistula cases between January 2005 and December 2017 at our tertiary academic center. Demographics, diagnostic approaches, and treatment outcomes were assessed. Nineteen cases of ureterovaginal fistula were identified. Fistulas developed after hysterectomy in 18 cases and cesarean delivery in 1 case. Our primary treatment was conservative management with ureteral stenting in 12 and reimplantation in 6 cases. There was 1 case of spontaneous resolution. Ureteral stenting was successful in 11 (92%) of 12 patients. Stents were left in place for an average of 66 days (27-92 days). Complications of stents included pyelonephritis in 2 cases (18%) and stricture in 1 case (9%). Ultimately, conservative management was successful in treating ureterovaginal fistulas in 10 (83%) of 12 cases. The indications for primary ureteral reimplantation were concurrent vesicovaginal fistula in 3 cases, history of ureteral injury with surgical repair during the index surgery in 2 cases, and a 1-year delay in diagnosis in 1 case. A variety of follow-up surveillance methods were used, includin...Continue Reading

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Citations

Nov 12, 2020·International Urogynecology Journal·Seyed Mohammadreza Rabani, Seyedhossein Rabani
Apr 28, 2021·Clinical Obstetrics and Gynecology·Megan Abrams, Rachel Pope
Dec 15, 2020·Journal of Minimally Invasive Gynecology·Douglas LuchristtKimberly Kenton
Jan 16, 2022·Neurourology and Urodynamics·Gunjan BahugunaChristopher Chapple

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