Ocena wlasnej techniki chirurgicznego leczenia pooperacyjnej przetoki p??cherzowo-pochwowej u chorych z rakiem szyjki macicy


Author(s): Juliusz Kobierski, Hanna Olszewska, Karolina Agnieszka Golka, Janusz Emerich

Introduction: Genitourinary fistulas result most commonly from pelvic surgery and might constitute a problem in patients treated radically for cervical cancer. The most frequently observed are vesicovaginal fistula (VVF) and ureterovaginal fistula. Nowadays various surgical techniques aimed to repair VVF as well as methods providing adequate post – operative bladder drainage are used.

Aim: The aim of the study is an evaluation of our own modified surgical technique in VVF repair.

Material and methods: The retrospective study of three patients with postsurgical VVF previously treated for cervical cancer with radical hysterectomy alone was presented. The own modification of surgical technique of the fistula closure used in the Department of Gynecology, Medical University of Gdansk was shown.

Results: Three patients with FIGO IB2 cervical cancer were treated by Wertheim – Meigs procedure. After 5 – 6 weeks’ time each of these women developed VVF, which was closed by standard transvaginal layered repair. The primary fistula closure procedure failed in all of the patients with symptoms of vaginal urine discharge presenting on the 16, 21 and 25th day following the operation. The next modified surgical procedure was performed. During that operation the ureters were catheterized and the catheters were connected together with the Foley catheter extended by the urethra. The margin of the fistula was circumcised. The VVF was repaired with absorbable sutures in 3 layers closure in each of these patients. These three recurrences were all successfully repaired in a second operation. There were no post – operative complications and no evidence of recurrent fistula.

Conclusion: The own modification of surgery in VVF repair is the valuable procedure and might stand the worthy supplement of the vaginal surgical techniques.

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Editors List


    Submitted PhD thesis in Biotechnology at GITAM University, Vizag.

  • Yousef Alomi

    Yousef Alomi
    The Past Head, General Administration of Pharmaceutical Care at Ministry of Health,
    Saudi Arabia Critical Care/TPN
    Clinical Pharmacist Ministry of Health,
    Riyadh, Saudi Arabia.

  • Osamu Tanaka

    Osamu Tanaka
    Assistant Professor,
    Department of Radiation Oncology
    Asahi University Hospital
    Gifu city, Gifu, Japan

  • Maher Abdel Fattah Al-Shayeb

    Department of Surgical Sciences, Ajman University, UAE

  • Andrzej Zdziennicki

    Institute of Gynecology and Obstetrics, Medical University of Lodz, I Clinic of Gynecology and Gynecological Oncology (Lodz, Poland)

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