Luigi Frigerio

Monduzzi Ed. pag. 33-36. 1990
( in coll. P. Guarnerio, S. Ferrari, A. Ferrari )
Summary: Once vaginal fistulae represented the consequence of obstetric trauma. Actually this complication is often the consequence of surgical treatment or combined radiotherapic approach for pelvic pathology. From 1970 to 1989 we treated 113 cases of vaginal fistulae: 49 cases are related to benign pathology and 64 cases are consequence of pelvic malignancy therapy. We treated 26 urinary fistulae, 76 faecal fistulae and 11 combined urinary and faecal fistulae. The elevate number of intestinal fistulae suggests a major morbosity related to combined treatment of gynecologic cancer surgery and radiotherapy. Our data suggest the opportunity to prevent and recognize urinary and intestinal lesions during operative procedure. We used derivative surgery in 49 cases when advanced radiotherapic effects and complicated fistulae were following oncologic surgery. A better confidence with different factors related to fistulae etiology and a good aknowledgment of surgical and radiotherapic tecniques will prevent the incidence of this severe clinical complication.