Outcome of urogenital tract fistula at jinnah post graduate medical centre (jpmc) karachi pakistan

Objective: Find out the outcome of surgical management of Urogenital Tract Fistulas in term of recurrence rate, complications and to understand the magnitude of this problem with its etiology. Methods: This was a retrospective study conducted in Department of Urology at Jinnah Postgraduate Medical Centre, Karachi from January 2004 to July 2012. All patients presented during study period with Urogenital Tract Fistulas secondary to obstetrics and surgical complications were included in this study. The patients with fistula secondary to malignancy and radiation therapy were excluded. Results: Forty-two (42) fistulas were repaired, among them 34 women had vesico-vaginal fistula (VVF), uretero-vaginal fistula (UVF) were found in 6 patients, while combined uretero and vesico-vaginal fistulas in 2 patients. In our study the mean age is 32.4 year + 3.7 (range 23-45 years). 85.7% (n=36) of patients belonged to rural areas of country and 14.28% (n=6) were urban in origin. Only 16.7% (n=7) were primigravida. Repair was successful in 97.62% (n=41) patients. Except 2.38% (n=1) had recurrence at 3 months follow up. Conclusion: The most common etiology was prolonged obstructed labor. Only one recurrence was noted in this series. The reason being the correct timing of surgery (3-4 months)following initial accident, meticulous tissue handling, control of infection and adequate nutritional support pre- operatively.