E5084. Value of Multimodality Imaging of Urogenitial Fistulas in Male and Female Patients
  1. Ahmed Sobieh; University of Kentucky
  2. Teebro Rahman; University of South Carolina
  3. Jancarlo Lugo; University of Kentucky
  4. Elhamy Heba; University of Kentucky
  5. Adib Karam; University of Massachusetts
Urogenital fistulas are abnormal connections between the urinary tract, i.e., the urinary bladder, ureter, or urethra, and the male and female genital tract. It varies in different countries. In developing countries, urogenital fistulas occur as a complication of obstructed labor. In developed countries, fistulas are not common and occur as a sequela of gynecological or pelvic surgeries. Fistulas may form in men, but to a much lesser extent than in women, due to different anatomic relations. Other causes include pelvic inflammatory diseases, malignant neoplasms, pelvic radiotherapy, and urological surgical procedures. Fistulas can result in stool or urine leakage from unexpected openings. Purpose of this exhibit is to be able to know the appropriate imaging study for genitourinary fistulas. To describe the location and size of the fistula, i.e., the radiological findings, of the common urogenital fistulas, and to assess the cause of the fistula formation.

Educational Goals / Teaching Points
1. Incidence and etiology of urogenital fistulas in men and women. 2. Discuss various imaging techniques/protocols for proper diagnosis of urogential fistulas. 3. Review imaging features of urogenital fistulas, including multimodality case-based review of typical and challenging cases with clinical correlation. 4. Review of prognosis, management, and posttreatment imaging of urogenital fistulas.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
In this exhibit, example of cases that we will present cases for (1) lower ureteric fistulas: ureterovaginal fistula and ureteroenteric fistula; (2) bladder fistulas: enterovesical fistula, vesicovaginal fistulas, vesicouterine fistulas, and vesicocutaneous fistulas; (3) uretheral fistulas: uretherorectal fistula and urethrogenital fistula.

Urogenital fistulas are serious medical problems that affect quality of life of patients with significant morbidity. Appropriate and timely diagnosis is important to guide medical or surgical intervention to prevent serious complications.