Journal of Ultrasound in Medicine, Vol 19, Issue 4 243-249, Copyright © 2000 by American Institute of Ultrasound in Medicine
Obstetric fistula: evaluation with ultrasonography
V. A. Adetiloye and F. O. Dare
Department of Radiology, College of Health Sciences, Obafemi Awolowo University Ile-Ife, Nigeria.
Twenty-two patients with 24 fistulae were examined prospectively with
real-time sonography. Sonographic findings were compared with those of
intravenous urograms and correlated with the findings at examination under
anesthesia and at surgery. Various genital abnormalities not revealed by
intravenous urography were demonstrated by sonography preoperatively. These
included cervical injuries, vesicovaginal fistula showing "flat tire" sign
and hourglass deformities, and identification of the site, size, and course
of fistulae in seven (29%) of the cases. However, the demonstration of the
fistulae by sonography is poor relative to that of examination under
anesthesia, in which 21 (87%) of the fistulae were identified. The factors
responsible for the difficulty in demonstrating the fistulae on sonography,
which included size and multiplicity, are discussed. Sonography is
complementary to examination under anesthesia in preoperative evaluation of
the patients with obstetric fistulae in general and in those with previous
unsuccessful repairs in particular.
