open access
Uretero-vaginal fistulas — clinical presentation, treatment and literature overview
- Department of Interventional Radiology and Neuroradiology, Medical University of Lublin, Poland
- Department of Endocrinology, Diabetology and Metabolic Diseases, Medical University of Lublin, Poland
- 2nd Department of Gynecology, Medical University of Lublin, Poland
- 3rd Department of Gynecology, Medical University of Lublin, Poland
open access
Abstract
A uretero-vaginal fistula (UVF) describes an abnormal connection between the ureter and vagina causing urinary incontinence, frequent infection, and discomfort. Although UVF might be diagnosed after vaginal delivery, infertility treatment or pelvic radiation therapy, gynecological operations, especially total abdominal hysterectomy, remain the leading cause of ureteral injury and formation of UVF. Traditional ureteroneocystostomy was usually the treatment of choice in patients with UVF. Nevertheless, it is now frequently replaced by less invasive endoscopic and percutaneous procedures which are also highly effective and feasible. That is why, ureteral stenting became the first-line treatment in uncomplicated UVF. The aim of this review is to present clinical presentation of UVF and to assess the current state of knowledge about the diagnosis and management of uretero-vaginal fistula with special interest on minimally-invasive methods.
Abstract
A uretero-vaginal fistula (UVF) describes an abnormal connection between the ureter and vagina causing urinary incontinence, frequent infection, and discomfort. Although UVF might be diagnosed after vaginal delivery, infertility treatment or pelvic radiation therapy, gynecological operations, especially total abdominal hysterectomy, remain the leading cause of ureteral injury and formation of UVF. Traditional ureteroneocystostomy was usually the treatment of choice in patients with UVF. Nevertheless, it is now frequently replaced by less invasive endoscopic and percutaneous procedures which are also highly effective and feasible. That is why, ureteral stenting became the first-line treatment in uncomplicated UVF. The aim of this review is to present clinical presentation of UVF and to assess the current state of knowledge about the diagnosis and management of uretero-vaginal fistula with special interest on minimally-invasive methods.
Keywords
uretero-vaginal fistula; post-operative; complication; minimally-invasive
Title
Uretero-vaginal fistulas — clinical presentation, treatment and literature overview
Journal
Issue
Article type
Review paper
Pages
501-505
Published online
2022-03-17
Page views
5040
Article views/downloads
1642
DOI
Pubmed
Bibliographic record
Ginekol Pol 2022;93(6):501-505.
Keywords
uretero-vaginal fistula
post-operative
complication
minimally-invasive
Authors
Krzysztof Pyra
Maciej Szmygin
Hanna Szmygin
Tomasz Jargiello
Tomasz Rechberger
Slawomir Wozniak
- Li X, Wang P, Liu Y, et al. Minimally invasive surgical treatment on delayed uretero-vaginal fistula. BMC Urol. 2018; 18(1): 96.
- Hosseini SY, Roshan YM, Safarinejad MR. Ureterovaginal fistula after vaginal delivery. J Urol. 1998; 160(3 Pt 1): 829.
- von Eye Corleta H, Moretto M, D'Avila AM, et al. Immediate ureterovaginal fistula secondary to oocyte retrieval — a case report. Fertil Steril. 2008; 90(5): 2006.e1–2006.e3.
- Ignatoff JM, Graham JB. Bilateral ureterovaginal fistula; complication of radiation therapy. Urology. 1974; 4(5): 585–589.
- Al-Otaibi KM. Ureterovaginal fistulas: The role of endoscopy and a percutaneous approach. Urol Ann. 2012; 4(2): 102–105.
- Akgör U, Kuru O, Güneş AC, et al. Impact of clinicopathological variables on laparoscopic hysterectomy complications, a tertiary center experience. Ginekol Pol. 2021 [Epub ahead of print].
- Stojko R, Malinowski A, Baranowski W, et al. Recommendations of the Polish Society of Gynaecologists and Obstetricians for removal of the uterus by vaginal, laparoscopic and abdominal routes. Ginekol Pol. 2020; 91(6): 352–361.
- Parpala-Spårman T, Paananen I, Santala M, et al. Increasing numbers of ureteric injuries after the introduction of laparoscopic surgery. Scand J Urol Nephrol. 2008; 42(5): 422–427.
- Mandal AK, Sharma SK, Vaidyanathan S, et al. Ureterovaginal fistula: summary of 18 years' experience. Br J Urol. 1990; 65(5): 453–456.
- Selzman AA, Spirnak JP, Kursh ED. The changing management of ureterovaginal fistulas. J Urol. 1995; 153(3 Pt 1): 626–628.
- Murphy DM, Grace PA, O'Flynn JD. Ureterovaginal fistula: a report of 12 cases and review of the literature. J Urol. 1982; 128(5): 924–925.
- Chen YB, Wolff BJ, Kenton KS, et al. Approach to ureterovaginal fistula: examining 13 years of experience. Female Pelvic Med Reconstr Surg. 2019; 25(2): e7–ee11.
- Raghavaiah NV. Double-dye test to diagnose various types of vaginal fistulas. J Urol. 1974; 112(6): 811–812.
- Shaw J, Tunitsky-Bitton E, Barber MD, et al. Ureterovaginal fistula: a case series. Int Urogynecol J. 2014; 25(5): 615–621.
- Brandes S, Coburn M, Armenakas N, et al. Diagnosis and management of ureteric injury: an evidence-based analysis. BJU Int. 2004; 94(3): 277–289.
- Gilmour DT, Dwyer PL, Carey MP. Lower urinary tract injury during gynecologic surgery and its detection by intraoperative cystoscopy. Obstet Gynecol. 1999; 94(5 Pt 2): 883–889.
- Councell RB, Thorp JM, Sandridge DA, et al. Assessments of laparoscopic-assisted vaginal hysterectomy. J Am Assoc Gynecol Laparosc. 1994; 2(1): 49–56.
- Goodwin WE, Scardino PT, Goodwin WE, et al. Vesicovaginal and ureterovaginal fistulas: a summary of 25 years of experience. Trans Am Assoc Genitourin Surg. 1979; 71(3): 123–129.
- Linder BJ, Frank I, Occhino JA. Extravesical robotic ureteral reimplantation for ureterovaginal fistula. Int Urogynecol J. 2018; 29(4): 595–597.
- Ramalingam M, Senthil K, Venkatesh V. Laparoscopic repair of ureterovaginal fistula: successful outcome by laparoscopic ureteral reimplantation. J Endourol. 2005; 19(10): 1174–1176.
- Boateng AA, Eltahawy EA, Mahdy A. Vaginal repair of ureterovaginal fistula may be suitable for selected cases. Int Urogynecol J. 2013; 24(6): 921–924.
- Chen SS, Yang SH, Yang JM, et al. Transvaginal repair of ureterovaginal fistula by Latzko technique. Int Urogynecol J Pelvic Floor Dysfunct. 2007; 18(11): 1381–1383.
- Schmeller NT, Göttinger H, Schüller J, et al. [Percutaneous nephrostomy as primary therapy of ureterovaginal fistula]. Urologe A. 1983; 22(2): 108–112.
- Dowling R, Corriere J, Sandler C. Iatrogenic ureteral injury. Journal of Urology. 1986; 135(5): 912–915.
- Elabd S, Ghoniem G, Elsharaby M, et al. Use of endoscopy in the management of postoperative ureterovaginal fistula. Int Urogynecol J Pelvic Floor Dysfunct. 1997; 8(4): 185–190.
- Rajamaheswari N, Chhikara AB, Seethalakshmi K. Management of ureterovaginal fistulae: an audit. Int Urogynecol J. 2013; 24(6): 959–962.
- Lingeman JE, Wong MY, Newmark JR. Endoscopic management of total ureteral occlusion and ureterovaginal fistula. J Endourol. 1995; 9(5): 391–396.