Interposing layer of fibrin glue: A new horizon in vesico-vaginal fistula repair

Aim: In this study our idea is to compare the effectiveness of using interposing layer of fibrin glue to omental flap in reducing the failure of laparoscopic vesicovaginal fistula repair. Methods: Forty patients with fairly large vesicovaginal fistula were enrolled and divided in two groups of 20 each. We have used fibrin glue in one group and omental flap in the other group. Result: Of 20 patients in fibrin glue group no failure was seen, while 5 patients out of 20 in omental flap group had failure. Conclusion: This result is statistically significant and hence use of fibrin glue to be considered during laparoscopic repair of vesicovaginal fistulas.

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Robotic vesico-vaginal fistula repair with no omental flap interposition

International Urogynecology Journal ◽

10.1007/s00192-016-2989-5 ◽

2016 ◽

Vol 27 (8) ◽

pp. 1277-1278 ◽

Cited By ~ 2

Author(s):

Alberto Martini ◽

Eugenio Dattolo ◽

Jacopo Frizzi ◽

Donata Villari ◽

Maria Cristina Paoletti

Keyword(s):

Omental Flap ◽

Vaginal Fistula ◽

Fistula Repair ◽

Vesico Vaginal Fistula

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O’CONOR (TRANSABDOMINAL) REPAIR: IS IT ALWAYS NECESSARY TO INTERPOSE A FLAP IN SIMPLE VESICO-VAGINAL FISTULA? A COMPARATIVE STUDY

Pakistan Armed Forces Medical Journal ◽

10.51253/pafmj.v71i1.3599 ◽

2021 ◽

Vol 71 (1) ◽

pp. 347-50

Author(s):

Qamar Zia ◽

Asma Rizwan ◽

Adil Khurshid ◽

Mudassar Sajjad ◽

Muhammad Nawaz ◽

...

Keyword(s):

Comparative Study ◽

Vesicovaginal Fistula ◽

Armed Forces ◽

Vaginal Fistula ◽

Fistulous Opening ◽

Vesicovaginal Fistulae ◽

Group A ◽

Prospective Comparative Study ◽

Group B ◽

Vesico Vaginal Fistula

Objective: To assess morbidity and success of transabdominal (O’Conor) repair of vesicovaginal fistula with orwithout interposition of flap between vagina and urinary bladder. Study Design: Prospective comparative study. Place and Duration of Study: Armed Forces Institute of Urology, Rawalpindi, from Mar 2016 to Jan 2019. Methodology: Fifty five patients were randomized into group A & B by lottery method. An inclusion criterionwas single fistulous opening of ≤3cm. Complex and recurrent fistulae were excluded. Patients in group A underwent O’Conor repair without interpositional flap while in group B vesicovaginal fistulae were repaired with flap interposition. Results: Twenty two patients were randomized in group A while 27 in group B. Mean age of patients was 41.65± 11.93 years. Gynecological and obstetrical surgery was the main cause of fistula. Mean duration of surgerywas 162.7 ± 18.49 minutes. Per-operative ureteric catheterization was done in 9 (16.8%) patients. Seventeen(30.6%) patients had paralytic ileus. There was transient fever in 4 (7.6%) of cases and wound infection was seenin 3 (5.8%) of patients. Mean hospital stay was 3.4 ± 2.3 days. Cystogram was done in 35 (64.5%) of patients before the removal of per-urethral catheter. The overall success rate was 92.9%. Ten (18.2%) of patients developed denovo urgency which was managed conservatively. There was no statistical difference in both groups in terms of morbidity and success. Conclusion: In simple Vesico-vaginal fistulae repair, interposition of flap can be omitted and it does not affect the outcomes in terms of success and morbidity.

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Dr James Marion Sims – kontrowersyjny „ojciec ginekologii”

Nowa Medycyna ◽

10.25121/nm.2021.28.1.30 ◽

2021 ◽

Vol 28 (1) ◽

Author(s):

Maria Ciesielska

Keyword(s):

African American Women ◽

Common Complication ◽

Vaginal Fistula ◽

Clinical Context ◽

Early 19Th Century ◽

American Women ◽

Attitudes And Practices ◽

Human Experiments ◽

Vesicovaginal Fistulas ◽

Vesico Vaginal Fistula

Vesico-vaginal fistula (VVF) was a a catastrophic and common complication of childbirth among American women. In the mid 1800s Dr. J. Marion Sims reported the successful repair of vesicovaginal fistulas with a technique he developed by performing multiple operations on on a group of young, enslaved, African American women who had this condition between 1846 and 1849. Numerous modern authors have attacked Sims’s medical ethics, arguing that he manipulated the institution of slavery to perform ethically unacceptable human experiments on powerless, unconsenting women. It is impossible to understand Sims’s operations within the clinical context of the 1840s. To avoid the problems of “presentism”, in which beliefs, attitudes, and practices of the 21st century are anachronistically projected backward into the early 19th century we have to judge Sims within the context of his time. This is the only way to understand that Sims’ first fistula operations were legal, that they were carried out with express therapeutic intent for the purpose of repairing these women’s injuries, that they conformed to the ethical requirements of his time, and that they were performed with the patients’ knowledge, cooperation, assent, and assistance. Though the legacy of Dr. Sims is for some authors controversial he still seems to be considered as “the father of gyncology” who developed the first consistently successful surgical technique for the vesico-vaginal fistula.

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