Urinary tract fistulas following ligation of the internal iliac artery during radical hysterectomy.
One hundred patients underwent radical hysterectomy at the University of South Florida over a 4 1/2-year period. In all patients the anterior division of the internal iliac artery was ligated on the left, and the uterine artery was ligated at its origin from the internal iliac artery on the right. One patient developed a left ureterovaginal fistula for a urinary tract fistula rate of 1%. Preservation of the distal branches of the anterior division of the internal iliac artery may help prevent urinary tract fistulas following radical hysterectomy. This study would suggest, however, that this of minimal importance.