Ureterovaginal Fistula: A Report of 12 Cases and Review of the Literature

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Abstract
Ureterovaginal fistula is an uncommon complication of pelvic operations, seen most often after Wertheim''s hysterectomy. Cases (12) of ureterovaginal fistulas seen during a 20 yr period, all of which followed operations for benign gynecologic condtions were reported. Most patients had no urinary symptoms until the sudden onset of incontinence 1-4 wk postoperatively. Diagnosis was established readily by a combination of excretory urography, cystography, cystoscopy, retrograde pyeloureterography and dye studies. Only 1 patient was treated by primary nephrectomy, while 11 underwent ureteroneocystostomy: 2 with a Boari flap and 9 by a direct method. Reconstruction failed in 2 patients, 1 of whom required a secondary nephrectomy.