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Voiding patterns and urinary control after repair of giant vesicovaginal and vesicourethrovaginal fistulas and neourethral construction
Author(s) -
Bissada Nabil K.,
Morcos Rafik R.
Publication year - 1986
Publication title -
neurourology and urodynamics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 90
eISSN - 1520-6777
pISSN - 0733-2467
DOI - 10.1002/nau.1930050314
Subject(s) - medicine , vesicovaginal fistula , surgery , fistula , urinary incontinence , vaginal fistula , urinary fistula , urinary diversion , urinary system , bladder cancer , cancer , cystectomy
Twenty‐six patients, 10 with giant vesicovaginal fistulas and 16 with vesicourethrovaginal fistulas, who underwent fistula repair (12) or fistula repair and neourethral construction (14) were evaluated 1 to 6 months postoperatively for adequacy of their urinary storage and evacuation. The ten patients with giant vesicovaginal fistulas and two patients with giant vesicourethrovaginal fistulas, in whom the urethral involvement was minimal, were managed solely by repair of their fistulas. Eleven of these 12 patients (92%) are continent and one has mild stress urinary incontinence. Of the 11 continent patients, nine have normal voiding and two void by straining. Five patients with extensive urethral involvement were managed initially by fistula repair that did not alleviate their incontinence. Fourteen patients with vesicourethrovaginal fistula and extensive urethral involvement were managed by simultaneous or nonsimultaneous fistula repair and neourethral construction. Ten of these patients (71 %) became continent. Continence rate was better in those who had no suprapublic operations prior to neourethral construction. In spite of attainment of continence in the majority of these patients, those with extensive urethral involvement did not regain normal evacuation function.