N Rajamaheswari1, Archana Bharti Chhikara, K Seethalakshmi. 1. Department of Urogynaecology, Government Kasturba Gandhi Hospital & Institute of Social Obstetrics, Madras Medical College, Trilplicane, Chennai, Pin 600005, India.
Abstract
INTRODUCTION AND HYPOTHESIS: A retrospective study was done from January 2008 to January 2011 to analyze the outcome of ureterovaginal fistula management in relation to intervention mode. PATIENTS AND METHODS: Eighteen patients who developed ureterovaginal fistulae following gynecological and obstetric procedures were studied. Ureteroscopic stenting was attempted in 17 cases, and one patient electively underwent ureteral reimplantation. RESULTS: Ureteroscopic stenting was successfully accomplished in 13 of 17 patients; four patients underwent ureteral reimplantation, as stenting was not feasible. The success rate was 100 % at a mean follow-up of 24.6 months, irrespective of modality. CONCLUSION: The majority of iatrogenic ureterovaginal fistulae can be successfully managed by ureteroscopic stenting. Our study also suggests that ureteroscopic stenting should be considered as the primary mode of intervention in all cases. Ureteral reimplantation is required and remains practicable when stenting turns out to be impossible.
INTRODUCTION AND HYPOTHESIS: A retrospective study was done from January 2008 to January 2011 to analyze the outcome of ureterovaginal fistula management in relation to intervention mode. PATIENTS AND METHODS: Eighteen patients who developed ureterovaginal fistulae following gynecological and obstetric procedures were studied. Ureteroscopic stenting was attempted in 17 cases, and one patient electively underwent ureteral reimplantation. RESULTS: Ureteroscopic stenting was successfully accomplished in 13 of 17 patients; four patients underwent ureteral reimplantation, as stenting was not feasible. The success rate was 100 % at a mean follow-up of 24.6 months, irrespective of modality. CONCLUSION: The majority of iatrogenic ureterovaginal fistulae can be successfully managed by ureteroscopic stenting. Our study also suggests that ureteroscopic stenting should be considered as the primary mode of intervention in all cases. Ureteral reimplantation is required and remains practicable when stenting turns out to be impossible.