Role of Intravenous Urography and Ultrasonography in the Management of Vesicovaginal Fistula (VVF)

Abstract

Background: It has been a matter of great controversy whether the sonography (USG) and intravenous urography (IVU) both are mandatory for the evaluation of hydronephrosis and hydro ureter in female patients having urinary fistulae. So we planned to conduct a study on this subject. Objectives: To compare the sensitivity of IVU and USG in showing the degree of Hydro nephrosis and hydro ureter in the patients having VVF. Study Design: Prospective study. Place and Duration of Study: Department of Urology Punjab Medical College /Allied Hospital Faisalabad from January 2013 to October 2014. Methodology: Thirty consecutive female patients suffering from urinary incontinence who presented in outpatient department and were diagnosed to have VVF were taken for study.  Patients with urge incontinence, patients with malignancy, patients who underwent surgery or received

radiation were excluded from this study. Informed consent for study purpose and surgery were taken. USG and IVU were done in every patients to find the hydronephrosis or hydro ureter. Results: Twenty seven out of thirty patients who had not hydronephrosis on USG, they also had not hydronephrosis or hydro ureter on IVU, while only three patients had hydronephrosis on USG had also hydronephrosis on IVU. Conclusion: This study concluded that USG and IVU have almost equal sensitivity in finding hydro nephrosis or hydro ureter in patients having VVF. Therefore, any one of them can suffice to find out hydronephrosis. IVU is an invasive procedure and have the risk of reaction to contrast material and exposure to radiations. USG is cost effective, non-invasive and hence can be used in place of IVU.