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학술저널
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연세대학교 의과대학 Yonsei Medical Journal Yonsei Medical Journal 제43권 제3호
발행연도
2002.1
수록면
315 - 319 (5page)

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This Surgical Outcome of Female Genital Fistula in Korea Sang Wook Bai1, Sung Hoon Kim1, Han Sung Kwon1, Koon Ho Rha2, Kyung Ah Chung1, Sei Kwang Kim1, and Ki Hyun Park1 Departments of 1Obstetrics and Gynecology, 2Urology, Yonsei University College of Medicine, Seoul, Korea. purpose of this study was to establish a new standard for the surgical management of female genital fistula in Korea. From January 1992 to October 2001, 117 patients with female genital fistula who were admitted to the departments of obstetrics and gynecology, urology and general surgery were analyzed. Nine patients with congenital etiologies and 48 patients who were treated conservatively were excluded. The relationships between surgical outcome and the cause of fistula, the location of fistula, and the various surgical methods were analyzed. In spite of appropriate surgical treatment, fistulas due to cervix cancer management had the worst prognosis. In terms of location, fistula recurrence after surgical repair was most common in the bladder fundus and base. The transvaginal and transrectal approaches are suitable for fistulas located in the lower vagina. The transabdominal approach is appropriate for fistulas located in the functional portions such as the bladder and ureter, for fistulas which are difficult to expose surgically by either the vaginal or rectal approach, or in cases with severe adhesions. In cases of cervix cancer, extra care should be taken during surgical expiration or definitive radiotherapy, especially when the areas involved are the bladder fundus and base. The nature of the surgical approach should be decided by the location of the fistula, the functional importance of the area, and the degree of surgical exposure during the corrective procedures.

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