Interposition of omentum,perivesical fat,martious fat in management of lower urinary tract fistula - A comparative study

Background: fistula of genitourinary tract is one of the severe complications of obstetrical & gynecological surgeries. by improvement of obstetrical care,incidence has reduced in west but the major etiological factor for fistula formation in develop world is pelvic surgeries. but in third world,this is one of the major issues related to obstetrical and gynecological procedures. this problem leads to medical issues,social isolation and psychological problems. aim: we want to compare the result of simple anatomical repair versus interposition of various tissues omentum,matrious flap and perivesical fat. method: we treated 64 cases of lower urinary tract fistulas after delivery,obstetrical procedures,pelvic surgery,fire arm injuries and road traffic accidents. among these 64 cases,54(84.4%) have vesicovaginal fistulas,3(4.7%) patients had vesicovaginal fistulas and rectovaginal fistula while 3(4.7%) have vesicovaginal fistulas associated with urethrovaginal fistula,2(3.1%) cases of each uterovaginal fistula and cervicovaginal fistula. conclusion: among the fistulas of lower urinary tract,vesicovaginal fistula is the commonest. hysterectomy is one of the leading cause of these fistulas. interposition of various tissues enhances the success rate and highly effective method of fistula closure. © 2016,lahore medical and dental college. all rights reserved.