الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Urogenital fistula is a global healthcare problem associated with obstetric complications in developing world and in the developed world occurs usually as a complication gynecological process.
The primary role of imaging in genitourinary fistulas is to confirm the diagnosis of clinically diagnosed genitourinary fistula, confirm or exclude the greatest spectrum of other pathologic abnormalities that could result in a clinical setting of vaginal urinary loss (as it is the commonest clinical presentation) and demonstrating abnormalities in the urinary tract, adjacent abdominal and pelvic structures.
Multi detector CT the preferred imaging modality in patients who are unable to tolerate fluoroscopy and MR imaging. Also it has the advantages over intravenous urography and fluoroscopic study include the ability to detect and characterize extra-urinary findings (e.g., common fluid collections, intestinal complications, tumor recurrence) .it can provides additional information regarding the etiology of the fistula and the extent of extra luminal disease. Such information has an important implication for patient management and is particularly useful when planning surgical repair. CT is easily available these days at most centers, providing images that are easy to interpret. In addition, CT not limited by the body habitus or the presence of abundant stool or intestinal gas, this may hinder evaluation with intravenous urography.
This study was performed in the Radio diagnosis Department in Alexandria Main University Hospital on 19 patients, 18 patient referred to confirm diagnosis of genitourinary fistula before planning for the treatment and one patient was discovered incidentally in a trauma patient. Six patients (31.6 %) were males and thirteen patients (68.4 %) were females. The age of patients ranged from 16 years up to 75 years with a mean age of 49.31±16.45
Ten patients (52.6%) suffered from genitourinary fistula after surgery, with post-hysterectomy being the most common cause. The remaining nine patients; had other etiologies such as complicated diverticulitis which come on top of the list. Six patients (31.6 %) complained of constant wetting, four patients (21.1 %) were presented by fecaluria and dysuria. In two patients, incisional discharge was the complaint .The rest of the cases had other presentations such as repeated urinary infection or swelling with abdominal pain.
The included patients were subjected to Computed Tomography (the technique was tailored according to the suspected type of fistula. CTU being the technique which we used for detecting urinary fistulas.
In this study, CTU was the best imaging modality used for diagnosis of clinically suspected genitourinary fistulae and provide the surgeon the ability for actual delineation of the fistulas tract at the work station rather than the operating room so accurate planning for management.