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Genitourinary Fistula: epidemiology, changing trends in etiology and management: A tertiary care institute's perspective.
- Source :
-
Urologia [Urologia] 2024 May; Vol. 91 (2), pp. 243-248. Date of Electronic Publication: 2024 Mar 18. - Publication Year :
- 2024
-
Abstract
- Introduction: Urogenital fistula is a physically, socially and psychologically devastating condition for the patient. In developed countries, these fistulae are typically related to gynecological surgery, pelvic pathology like malignancy or post radiation therapy. In contrast, classical teaching is that urogenital fistulae in the developing countries like India are usually associated with prolonged labor and obstetric complications. This retrospective study conducted at a tertiary care health Institute shows a paradigm shift in epidemiology, etiology and management of genitourinary fistulae in India in recent times.<br />Methods: This retrospective study included patients undergoing surgical repair for various genitourinary fistulae at our institute from 2016 to 2022. Epidemiology, etiology, site, size and number of fistulae, clinical presentation, and management records of these patients were recorded and reviewed retrospectively.<br />Results: In our study, the mean age of the patients was 38.4 ± 10.2 years. Vesicovaginal Fistula (VVF) was found to be most common fistula in the study population (87.5%) followed by vesicouterine (7.1%) and urethrovaginal fistula (5.4%). The causes of genitourinary fistula were iatrogenic (73.2%), carcinoma of cervix (16.1%), obstructed prolonged labor (7.1%), and genitourinary tuberculosis (3.57%). Among the 48 vesicovaginal fistulas that underwent surgery, 45.8% were treated using a transvaginal approach, 29.2% were managed through a laparoscopic transabdominal repair, and 25% were addressed using a robotic approach. Recurrence occurred in 7.1% of the operated patients.<br />Conclusion: Enhanced healthcare services in the country have contributed to a decrease in the incidence of obstructed labor, subsequently reducing related injuries. Iatrogenic injuries resulting from gynecological surgeries and carcinoma cervix have given rise to more complex fistulas, necessitating the implementation of advanced treatment strategies.<br />Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
- Subjects :
- Adult
Female
Humans
Middle Aged
India epidemiology
Retrospective Studies
Urethral Diseases epidemiology
Urethral Diseases etiology
Urethral Diseases therapy
Urinary Fistula epidemiology
Urinary Fistula etiology
Urinary Fistula therapy
Vaginal Fistula epidemiology
Vaginal Fistula etiology
Vaginal Fistula therapy
Tertiary Care Centers
Vesicovaginal Fistula epidemiology
Vesicovaginal Fistula etiology
Subjects
Details
- Language :
- English
- ISSN :
- 1724-6075
- Volume :
- 91
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- Urologia
- Publication Type :
- Academic Journal
- Accession number :
- 38497528
- Full Text :
- https://doi.org/10.1177/03915603241238597