The management of genitourinary fistula in the third millennium

Gamal M. Ghoniem, Hussein Warda

Research output: Contribution to journalReview articlepeer-review

39 Scopus citations


Background A vesicovaginal fistula (VVF) is an abnormal fistulous tract between the bladder and vagina, causing continuous loss of urine via the vagina. VVF is a relatively uncommon condition, but there is a drastically higher prevalence in the developing world. Furthermore, iatrogenic postoperative VVF is most common in developed countries, compared to mainly obstetric trauma in developing countries. In this review we focus on the development of current management techniques for VVF. Methods Medline was searched to identify articles related to urogenital fistulae, including VVF. Based on these reports we focus on the aetiology, clinical presentation, diagnosis and management of VVF. This in-depth review includes the optimal surgical timing, different surgical approaches (including minimally invasive techniques such as laparoscopic and robotic surgery), recommendations for postoperative care, surgical complications, and the need for further research in the use of robotic surgery to treat this condition. Results In all, 60 articles were identified and included in this review; eight were related to the aetiology, 12 to diagnosis, and 40 to the management of VVF. A thorough evaluation of VVF is imperative for planning the repair. Although the surgeonís experience typically influences the surgical approach, special situations will dictate the best approach. Conclusion The treatment of genitourinary fistulae with robotic assistance continues to develop, but further research is necessary to fully understand the use of this technology.

Original languageEnglish (US)
Pages (from-to)97-105
Number of pages9
JournalArab Journal of Urology
Issue number2
StatePublished - Jan 1 2014
Externally publishedYes


  • Diagnosis
  • Evaluation
  • Management
  • Presentation
  • Vesicovaginal fistula

ASJC Scopus subject areas

  • Urology


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