Uretero-neocystostomy in the treatment of postoperative uretero-vaginal fistula

Nine patients with unilateral uretero-vaginal fistula afer hysterectomy were seen over a 9-year period. In 5 patients radical pelvic surgery combined with radiotherapy had been carried out because of carcinoma of the cervix. In one patient the fistula developed following total hysterectomy 18 years after radiotherapy because of a cervical carcinoma. In 3 patients hysterectomy had been performed for benign disease, uterine fibroids or fibroids combined with endometriosis. In one patient the fistula was successfully treated with an indwelling ureteral catheter for 7 days. In the other 8 patients uretero-neocystostomy was successful as regards vaginal urine leakage; following this procedure one kidney was lost in the follow-up period. It is concluded that in patients with uretero-vaginal fistula, uretero-neocystostomy can be performed with satisfactory results even when the patient has been treated for a cervical carcinoma by radiotherapy and radical surgery.