A case of massive transvaginal eversion of urinary bladder through a large vesicovaginal fistula is reported. It has developed by spillage of hyprochloride on prolapse uteri and accompanied with rectovaginal fistula. Satisfactory surgical repair of the fistula was obtained by reduction of bladder and urethral reconstruction using anterior bladder wall.
Fistula ; Prolapse ; Rectovaginal Fistula ; Urinary Bladder* ; Uterus ; Vesicovaginal Fistula

24 cases of urinary fistulae which were admitted to The Department of Urology, Chonnam University Hospital, during the period from Sept. 1968 to Aug. 1971 were analyzed clinically. 1. 15 cases of all fistulae were in women and 9 in men. 2. The most common age was from 30~35 years with 50%. 3. The most commonly involved site was bladder with 66% and the most common fistula type was vesicovaginal fistula (40%). 4. The most common etiology of vesicovaginal fistula was obstetrical cause 5. 11 cases (44%) of all fistulas occurred after the operation.
Female ; Fistula* ; Humans ; Jeollanam-do ; Male ; Urinary Bladder ; Urinary Fistula ; Urinary Tract* ; Urology ; Vesicovaginal Fistula

A clinical observation was made on 20 cases of vesicovaginal fistula admitted to the Department of Urology, presbyterian Medical Center during the period from Aug., 1970 through July. 1977 and the following results were obtained. 1. Among 36 cases of urinary tract fistula, the most commonly involved site was bladder(22cases) and the most common fistula type was vesicovaginal fistula (20cases). 2. Among 20 cases of vesicovaginal fistula, the most common age was between 30 and 50 years. 3. The most common etiology of vesicovaginal fistula was gynecological cause(9 cases). 4. The most common location of vesicovaginal fistula was trigone(13 cases) mainly. 5. On I.V.P. finding of vesicovaginal fistula, 11 cases were normal and 8 cases abnormal. 6. On cystoscopic findings of vesicovaginal fistula, 7 cases were normal, 11 cases abnormal, 3 cases combined with bladder stone and 1 case with vaginal stone. 7. On treatment of vesicovaginal fistula, suprapubic transvesical approach was performed in 9 cases, transvesical transperitoneal approach 4 cases, Foley catheter drainage 3 cases and ileal conduit 1 case. 8. Success rate of repair was 76.9%, suprapubic transvesical 66.7 % and transperitoneal transvesical 100%.
Catheters ; Drainage ; Fistula ; Protestantism ; Urinary Bladder Calculi ; Urinary Diversion ; Urinary Tract ; Urology ; Vesicovaginal Fistula*

The most common cause of vesicovaginal fistulasis injury to the bladder at the time of surgery. The operation most frequently responsible for vesicovaginal fistula formation is hysterectomy. The first successful transvaginal approach to vesicovaginal fistula repair was reported by Sims in 1838. Although many surgical procedures exist, there is no best approach for all patients with vesicovaginal fistula. However, it is an essential surgical principle that the fistulous tract and scar should be excised completely. Here we report our technique using a transurethral pointed electrode for the treatment of multiple, small vesicovaginal fistulas and its outcome.
Cicatrix ; Electrodes ; Humans ; Hysterectomy ; Urinary Bladder ; Vesicovaginal Fistula

Complete urethral loss with vesicovaginal fistula is very infrequently encountered by the urologist. Urethral reconstruction may be accomplished with either bladder or vaginal wall flap. Moreover, it usually is necessary to reinforce the continence of reconstructed urethra with a well-vascularized pedicle flap from either the Martius labial flap, gracilis, perineum, or rectus. We report a case of the complete urethral loss with vesicovaginal fistula treated successfully with bilateral Martius labial fat graft.
Female* ; Humans ; Perineum ; Transplants ; Urethra ; Urinary Bladder ; Vesicovaginal Fistula*

Vesicovaginal fistula (VVF) is a subtype of female urogenital fistula. VVF is an abnormal fistulous tract extending between the bladder and the vagina that allows the continuous involuntary leakage of urine into the vaginal canal. In addition to the medical sequelae from these fistulas, they often have a profound effect on the patient's emotional well-being. In the past it was mostly by obstetric causes. But now a days, posthysterectomy fistulas are most commonly seen. In 1914, Latzko published his partial colpocleisis technique for repair of posthysterectomy VVF, in which he employed the resection of scarred vaginal mucosa and a layered horizontal closure. Latzko's procedure has been cited, with his 95-100% success rates noted. Recently we experienced a case of huge vesicovaginal fistula. The patient is a 67-year-old woman with a history of constant urine leakage. The problem began after she had undergone total abdominal hysterectomy 30 years ago for uterine ruture. We repaired it by Latzko partial colpocleisis.
Aged ; Cicatrix ; Female ; Fistula ; Humans ; Hysterectomy ; Mucous Membrane ; Urinary Bladder ; Vagina ; Vesicovaginal Fistula*

A clinical observation was made on 10 cases with vesicovaginal fistulas and 5 cases with urethrovaginal fistulas admitted to the Department of Urology, Busan National University Hospital, during the period from January, 1976 to June, 1982. The following results were obtained. 1. The most prevalent age group of vesicovaginal fistula was in its forties to fifties. And that of urethrovaginal fistula was in its thirties to forties and up to twenties. 2. The most common cause of vesicovaginal fistula was total hysterectomy (60%), and that of urethrovaginal fistula was trauma (60%). 3. In 4 of 10 patients with vesicovaginal fistula, the duration between onset and repair of the fistula was 3 to 6 months. In 3 of 5 patients with urethrovaginal fistula, the duration was over 5 years. 4. The most common location of vesicovaginal fistula was the posterior wall of the bladder and that of urethrovaginal fistula was proximal one third of the urethra. 5. The two most common size of vesicovaginal fistula and urethrovaginal fistula were below 1.0 cm and 1.1 to 2.0 cm. 6. The surgical repair was performed in 14 patients. Surgical approaches were as follows; transvaginal in 3, transabdominal in 6 (with vesicovaginal fistula), transvaginal in 5 (with urethrovaginal fistula)patients. 7. The most common duration of catheter drainage in vesicovaginal fistula was 3 wks. And that of urethrovaginal fistula was 2 wks. 8. Vesicovaginal fistula was repaired successfully in 7 out of 9 patients (77.8%), and urethrovaginal fistula was repaired completely in all of 5 patients (100.0%). 9. Postoperative complications of vesicovaginal fistula and urethrovaginal fistula were seen in 3 and 2 patients respectively.
Busan ; Catheters ; Drainage ; Fistula* ; Humans ; Hysterectomy ; Postoperative Complications ; Urethra ; Urinary Bladder ; Urology ; Vesicovaginal Fistula

A clinical observation on the vesicovaginal repair was done on24 cases admitted to the Dep. of Urology, Keimyung University Hospital, during the period from 1971 through 1981. Vesicovaginal fistula can be surgically repaired via vaginal route or transvesical extraperitoneal or transperitoneal technique and the following results were obtained. 1. Overall success rate of vesicovaginal fistula repair was 71% and that of simplified transperitoneal transvesical approach was higher than conventional method (88%). 2. Excision of the fistulas were facilitated by continuing traction on the Foley catheter, vaginal insertion of assistant`s finger and sand bag application below hip. 3. Preoperative infection with scar tissue, short duration, large sized fistula, inadequate exposure and dissection of bladder from vagina turned out to be main factors of the operative failure. 4. Wide exposure with tension free closure of well-vascularized peritoneal flaps and the judicious interposition of pedicled omentum have produced the most encouraging results and supravesical diversion by ileal or colonic conduit can be avoided. 5. Previous attempts for surgical repair seemed to have relation with success rate.
Catheters ; Cicatrix ; Colon ; Fingers ; Fistula ; Hip ; Omentum ; Silicon Dioxide ; Traction ; Urinary Bladder ; Urology ; Vagina ; Vesicovaginal Fistula*

Vesicovaginal fistula may be a complication of gynecologic and obstetric procedures, of which abdominal hysterectomy remains as the most common cause. Although there are a number of transvaginal or transabdominal surgical techniques for the correction of this condition, we performed a laparoscopic repair to reduce the morbidity of the transabdominal approach. A 44-year-old woman presented with urinary incontinence after undergoing Cesarean hysterectomy for uterine atony eight years ago. After confirming her vesicovaginal fistula, laparoscopic repair was performed. The bladder and vaginal walls were mobilized by meticulous dissection and repaired by intracorporeal stitches in 2 layers followed by omental interposition. Total operative time was 3 and half hours and estimated blood loss was about 400 ml. Foley catheter was removed at 23rd day after operation. Patient was discharged at 26th day after confirming the complete correction of the fistula by cystogram. Laparoscopic repair of a vesicovaginal fistula appears to be a safe and effective procedure. We report this case with a brief review of literature.
Adult ; Catheters ; Female ; Fistula ; Humans ; Hysterectomy ; Laparoscopy ; Operative Time ; Urinary Bladder ; Urinary Incontinence ; Uterine Inertia ; Vesicovaginal Fistula

Ninety-six cases of urinary tract fistulas, which were admitted to Severance Hospital during the period from Jan. , 1960 to Dec. 1969, were analyzed clinically and statistically. They were investigated by comparing with previous papers. 1) The rate of urinary tract fistulas accounted for 2.4 per cent of the total admissions to the Urologic Department and 0.057 per cent of Obstetrics and Gynecologic Department during 10 years. Twenty-eight cases of all fistulas were in men and sixty-eight in women. The age distribution was much the same as that found in previous literature. The most common age was from 20~50 years with 91.7 per cent. 2) The most commonly involved site was the bladder with 64.5 per cent and the most common fistula type was vesicovaginal with 42.6 per cent of those involving bladder. 3) About forty-seven per cent of all fistulas occurred after previous pelvic operation, seventeen per cent due to carcinoma of pelvic organs and thirteen per cent due to abnormal delivery. Chemicals, radiation, infection, trauma, foreign body and stone of the urinary tract were listed frequently as an etiologic factors. 4) The incidence of ureteral injury during radical hysterectomy was variable in the literature, but it accounted for 10 per cent generally. Among the 10 per cent of ureteral injury, ureteral fistulas developed in 20 per cent of our cases, but in 12 per cent of Meig's. 5) There are many surgical approaches to repair urinary tract fistulas according to the surgeon's taste, fistula type, location, size or number, previous attempts and adhesion of surrounding tissues. No two fistulas are exactly alike, and surgical approach to any fistula must be well thought before the time of operation. The operation must be fitted to the fistula, not the fistula to the operation. 6) To repair urinary tract fistula is today a somewhat difficult problem, and the operative failure rate in our 41 cases of vesicovaginal fistula was 34.4 per cent.
Age Distribution ; Female ; Fistula* ; Foreign Bodies ; Humans ; Hysterectomy ; Incidence ; Male ; Obstetrics ; Ureter ; Urinary Bladder ; Urinary Tract* ; Vesicovaginal Fistula