Aetiological Pattern of Iatrogenic Urological Fistula; Is the Scenario Changing? | [Journal of Society of Obstetricians and gynaecologists of Pakistan • 2021]

Author(s):

1. Pushpa Srichand: Dept of Obs & Gynae, ISRA University Hospital, Hyderabad, Pakistan

2. Nabila Hassan: Dept of Obs & Gynae, LUMHS, Jamshoro

3. Najma Shaikh: Dept of Obs & Gynae, LUMHS, Pakistan

4. Farhat Sultana: Dept of Obs & Gynae, LUUMHS, Pakistan

5. Zarmeena Talpur: Civil Hospital, Matiari LUMHS, Jamshoro, Pakistan

6. Gul Farheen: Dept of Obs & Gynae, ISRA University Hospital Hyderabad, Pakistan

Abstract:

Objective: To determine the frequency of iatrogenic urogenital fistula and to find out whether there is any change in the aetiology of iatrogenic urological fistula with passage of time. Methodology: The retrospective case series study was conducted in Obstetrics & Gynecology Unit II, Isra University Hyderabad from January 1st, January 2007 to 31st December 2020. All patients with iatrogenic urogenital fistulae were included in the study. The risk factors leading to iatrogenic fistulae were determined in all admitted patients. The frequency of urogenital fistulae was determined, and two groups were compared to find out whether there is any change in the etiology of urogenital fistulae with the passage of time. For categorical variables, frequency and percentage were calculated, and a chi-square test was used to compare two groups. value of less than 0.05 was considered as statistically significant. Results: A total of 821 registered cases of urogenital fistulae with 429 cases of iatrogenic etiology, giving the frequency of 52%. There was increase in total cases of urogenital fistulae cases in Group "B" along with rising number of iatrogenic fistulae in comparison to group A, Iatrogenic injury during hysterectomy for gynecological conditions was the main cause of fistula formation, followed by iatrogenic injury to bladder during cesarean section with previous scarred uterus in Group B. There was a statistically significant rise of iatrogenic fistulae due to abdominal hysterectomy and cesarean section in group "B" (P<0.05) while a decline in iatrogenic fistula secondary to caesarean section in unscarred uteri and post-partum hemorrhage were found in group B. Conclusion: The number of iatrogenic urogenital fistula is rising in Pakistan. The main risk factor is iatrogenic injury at time of hysterectomy for gynecological conditions and cesarean section and cesarean hysterectomy. Considering the suboptimal care with rising trend of hysterectomies and caesarean sections, there is a particular need to raise the awareness about performing gynecological surgeries and caesarean section for trivial reasons in order in order to unnecessary surgeries.

Page(s): 234-237

DOI: DOI not available

Published: Journal: Journal of Society of Obstetricians and gynaecologists of Pakistan, Volume: 11, Issue: 4, Year: 2021

Keywords:

Risk Factors , Iatrogenic , Urogenital fistulae

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