Surgical repair of vesico-vaginal fistula: the need for an evidence-based approach

Objective: To evaluate the outcome of surgical repair in patients with vesico-vaginal fistula at Cipto Mangunkusumo Hospital. Material & Method: A retrospective study of 30 patients with vesico-vaginal fistula, who underwent surgical repair of the fistula at Urology Department Cipto Mangunkusumo Hospital between the period of 1998-2008, were reviewed. Patients were analyzed with regard to age, location of fistula, etiology, size of fistula, and surgical approach. The outcome of the surgery was analyzed. Results: This study included 30 patients who underwent surgery with age between 18-69 years old. The most common etiology was due to obstetrical trauma and hysterectomy. Bladder trigone was the most common location of fistulae (40%). During the surgery the transvesical (43%) approach was commonly used. However, the most excellent outcome was surgery by transvesical-transvaginal approach (100%). Success rate of fistula repair was 73%. Conclusion: This disease is a medically and psychosocially devastating condition for the patient. The diagnosis was easy but complicated in decision of treatment. Best results were observed by transvesical-transvaginal approach. Keywords: Vesico-vaginal fistulae, surgical approach, surgical outcome.

Download Full-text

Vesico vaginal fistula: prevention is possible

Annals of King Edward Medical University ◽

10.21649/akemu.v12i2.908 ◽

2016 ◽

Vol 12 (2) ◽

Author(s):

Zohra Khanum ◽

Humaira Akram

Keyword(s):

Urinary Tract ◽

Prospective Study ◽

Surgical Repair ◽

Age Group ◽

Vaginal Fistula ◽

A Prospective Study ◽

Fistula Prevention ◽

Vesico Vaginal Fistula ◽

Tract Fistula

A prospective study was conducted at Lady Willingdon hospital Lahore from Jan,2002 to Dec, 2004. During the mentioned period 22 patients were admitted with the diagnosis of urinary tract fistula. Among these most of the patients (i.e, 45%) were young belonging to age group 20-30 years. According to the causes 72 % were due to obstetrical causes, 23% due to surgical causes and 5 % were due to malignant. Regarding to the location of the fistula 14% were juxtauretheral,28% low vaginal, 35% mid vaginal,09% high vaginal and 14% were vault fistulae.Out of 22 patients first surgical repair failure occurred in four patients.

Download Full-text

Comparative analysis of outcome between laparoscopic versus open surgical repair for vesico-vaginal fistula

Obstetrics & Gynecology Science ◽

10.5468/ogs.2016.59.6.525 ◽

2016 ◽

Vol 59 (6) ◽

pp. 525 ◽

Cited By ~ 5

Author(s):

Bastab Ghosh ◽

Varun Wats ◽

Dilip Kumar Pal

Keyword(s):

Comparative Analysis ◽

Surgical Repair ◽

Vaginal Fistula ◽

Open Surgical Repair ◽

Vesico Vaginal Fistula

Download Full-text

VESICO-VAGINAL FISTULA REPAIR

The Professional Medical Journal ◽

10.29309/tpmj/2006.13.03.4996 ◽

2006 ◽

Vol 13 (03) ◽

pp. 445-452

Author(s):

MUMTAZ RASOOL ◽

FARIHA MUMTAZ ◽

SHAFQAT ALI TABASSUM

Keyword(s):

Surgical Repair ◽

Birth Trauma ◽

Vaginal Fistula ◽

Fistula Repair ◽

Previous Surgery ◽

Transvaginal Repair ◽

Age Range ◽

Inflammatory Changes ◽

Study Setting ◽

Vesico Vaginal Fistula

Objectives: To evaluate outcome of surgical repair of VVF with transabdominal and transvaginalapproaches. Design of study: Prospective study. Setting: Depart of Urology Bahawal Victoria Hospital Bahawalpur.Period: Jan 1999 to Dec 2004. Materials & Methods: All consecutive patients with VVF irrespective of age andaetiology were included in this study. Patients with very large VVF and involvement of bladder neck were excluded.These patients were analysed for results of surgical repair by trans-abdominal and transvaginal approaches. ResultsThis study included 26 patients with age range between 20-48 years (mean age of 34 years). Etiology of VVF wasobserved to be transabdominal hysterectomy in 15 patients, transvaginal hysterectomy in one patient. While obstructedprolonged labour caused VVF in 10 patients. Transabdominal repair was done in 18 patients while 08 patients haveundergone transvaginal repair after investigations and evaluation. We achieved 94.45% success with transabdominalrepair of VVF while 100% success with transvaginal repair. Conclusions:The etiology of this disease is preventable.It is best to wait for at least 03 months after occurrence of VVF, so that inflammatory changes due to previous surgery/birth trauma may have settled completely before attempting at repair. Best resultrs are achieved at first attempt ofrepair. Both approaches of surgical repair of VVF have good results.

Download Full-text

Obstetric Fistula: a retrospective study of 413 cases in Haut-Katanga Province, Democratic Republic of Congo

10.21203/rs.3.rs-16149/v1 ◽

2020 ◽

Author(s):

Joseph B. Nsambi ◽

Olivier Mukuku ◽

Prosper L. Kakudji ◽

Robert Andrianne ◽

Jean-Baptiste S.Z. Kakoma

Keyword(s):

Democratic Republic ◽

Surgical Repair ◽

Democratic Republic Of Congo ◽

Obstetric Fistula ◽

Vaginal Fistula ◽

Obstructed Labor ◽

Severe Condition ◽

Type Size ◽

The Mean ◽

Vesico Vaginal Fistula

Abstract Background: In developing countries, fistulae are generally caused by long obstructed labors. Obstetric fistula (OF) is a severe condition which can have devastating consequences for a woman’s life.This study aims to describe the socio-demographic and delivery characteristics of patients with OF in Haut-Katanga province in the Democratic Republic of Congo.Methods: This is a prospective descriptive study of 413 patients with OF in Haut-Katanga province during the period from September 2009 to December 2018.Results: At fistula occurrence, 53.3% of patients were younger than 20 years (mean age: 21.3 ± 6.7 years) and 65.8% were primiparous. More than half had primary education and 39.7% were illiterate; 70.2% of the patients were separated or divorced. Fistula developed after delivery at home in 239 (57.9%) of 413 women. A total of 393 (95.2%) women developed fistula after vaginal delivery. A total of 387 (93.7%) of the 413 women reported that the fetus did not survive the labor during which fistula developed. 92.3% had a vesico-vaginal fistula and the mean age of fistula was 6.5 years. Surgical repair was successful in 82.9%.Conclusion: Obstructed labor remains the most important cause of OF in Haut-Katanga. It is important to prevent OF arising from obstructive causes. The surgical treatment of OF will depend upon the type, size and location of fistula.

Download Full-text