Table 2 Characteristics of patients with genitourinary fistulas
From: Evaluation and management of obstetric genital fistulas treated at a pelvic floor centre in Germany
Patient number | Type of urogenital fistula and fistula characteristics | Mode of delivery leading to fistula formation | Age at time of fistula diagnosis (years) and parity | Previous treatment | Fistula treatment in our department |
|---|---|---|---|---|---|
1 | VVF Diameter: 3 mm Location: vaginal apex/vesical trogone | 07/2015 Caesarean section and total hysterectomy due to placenta previa percreta | 36, 3 para | 09/2015 abdominal fistula excision and closure with peritoneal flap interposition | 03/2016 vaginal fistula excision, tension-free multilayer closure |
2 | VVF Diameter: 20 mm Location upper third of the anterior vaginal wall close to the cervix/vesical trigone | 09/2014 caesarean section with intraoperative bladder injury | 35, 2 para | 09/2014 abdominal VVF closure | 01/2015 abdomino-vaginal fistula excision and tension-free multilayer closure with omentum majus flap interposition |
3 | VVF with involvement of the cervix uteri Diameter: 30 mm Location: upper third of the anterior vaginal wall and cervix/vesical trigone | 11/2017 caesarean section with intraoperative bladder injury | 29, 2 para | Ureteral stents placement 04/2018 vaginal fistula excision, tension-free multilayer closure and Martius- Flap interposition 06/2018 abdomino-vaginal rest fistula (2 mm) excision and closure using an omentum majus flap | |
4 | VVF with involvement of the cervix uteri Diameter: 40 mm Location: upper third of the anterior vaginal wall and cervix/vesical trigone | 03/2016 caesarean section | 33, 2 para | Ureteral stents placement 07/2016 abdomino-vaginal fistula excision and closure with concomitant hysterectomy using an omentum majus flap 01/2017 vaginal rest-fistula (5 mm) excision and closure with Martius-Flap interposition | |
5 | VVF with involvement of the cervix uteri Diameter: 20 mm Location: upper third of the anterior vaginal wall and cervix/posterior bladder wall | 12/2011 forceps assisted delivery | 36, 2 para | 01/2012 vaginal tension-free multilayer closure and cervix reconstruction 04/2012 abdomino-vaginal rest-fistula (3 mm) excision and closure with an omentum majus flap | |
6 | Vesico-uterine fistula Diameter: 3 mm Location: supratrigonal/upper third of the right cervical wall | Spontaneous delivery 1982 | 66, 2 para | 06/2020 | |
7 | Vesico-uterine fistula Diameter: 15 mm Location: posterior baldder wall/cervix | 07/2018 caesarian section and supracervical hysterectomy (due to haemorrhage) and bladder injury | 33, 2 para | 10/2018 abdomino-vaginal tension free multilayer fistula closure with removal of the cervix and omentum majus flap interposition | |
8 | Vesico-uterine fistula Diameter: 30 mm Location: posterior bladder wall/isthmus uteri | 2011 caesarian section | 37, 3 para (the fistula was diagnosed in pregnancy) | 02/2017 caesarian section and abdominal tension free multilayer fistula closure with bioimplant (Serasis Firma Cook) interposition | |
9 | Vesico-uterine fistula Diameter: 3 mm Location: posterior bladder wall/isthmus uteri | 8/2016 caesarian section with bladder injury | 38, 1 para | 06/2017 vaginal fistula excision and tension free multilayer fistula closure with martius-flap interposition | |
10 | Vesico-utero-vaginal fistula Diameter 30 mm Location: upper third of the anterior vaginal wall/anterior wall of the uterus above the cervix/vesical trigone | Spontaneous delivery | 29, 1 para | Ureteral stents placement 11/2019 abdomino-vaginal fistula excision and tension-free multilayer closure of the bladder, uterus and vagina with omentum majus flap interposition | |
11 | Urethro-vaginal fistula Diameter: 25 mm | 2016 Spontaneous delivery | 26, 2 para | 11/2019 Urethra reconstruction (using a graft from labium minus) and Martius-flap interposition |