scholarly journals Success Rate of Urogenital Fistula Repair and Predictors of Success-An Audit of Ten Years Data

2018 ◽  
Vol 13 (2) ◽  
pp. 15-18
Author(s):  
Nasira Tasnim ◽  
Kauser Bangash ◽  
Oreekah Amin ◽  
Afshan Batool ◽  
Nosheela Javed
Keyword(s):  
Success Rate ◽  
Vesicovaginal Fistula ◽  
Surgical Repair ◽  
Previous Attempt ◽  
Medical Sciences ◽  
Fistula Repair ◽  
Urogenital Fistula ◽  
History Of ◽  
Repair Attempts ◽  
And Child Health

Aims: To evaluate the association of various predictive factors with the outcome of surgical repair of vesicovaginal fistula. Methods: The retrospective analysis was conducted at Maternal and Child Health, Pakistan Institute of Medical Sciences, Islamabad, and it comprised data related to patients having undergone vesicovaginal fistula repair from January 2008 to June 2018. Statistical analysis of the record was done using SPSS 21 software. Results: A total of 364 patients of urogenital fistula repair were reviewed, with an overall success in 318 (87.4%) cases. There were no significant differences in fistula duration (p0.4), size of fistula (p 0.34) and accessibility (p0.5) between successful and unsuccessful group. However, we found the association between the type of fistula and history of previous repair attempts with the success of fistula repair. Primary surgical repair of vesicovaginal (90.0%), vesicouterine (86%), ureteric (100%) and ureterovaginal (98%) were more successful as compared to repair with the history of 1 previous attempt (90.3%, 83.3%, 66.6% and 75% respectively). Success rate was found to further decrease with the history of more than one repair attempt of vesicovaginal (71.4%) and vesicouterine (66.5%) fistula. Further, successful fistula repair in women was also found to be significantly associated with parity less than 4 (p 0.038). Conclusion: Despite the higher success rate of urogenital fistula repair, it’s important to refer the urogenital fistula patients timely to specialized fistula centres in order to achieve best results.

scholarly journals Predictors of Successful Urogenital Fistula Repair and Incidence of Urinary Problems Post Successful Fistula Repair

2018 ◽  
Vol 13 (2) ◽  
Author(s):  
Nasira Tasnim ◽  
Kauser Bangash ◽  
Oreekha Amin ◽  
Afshan Batool ◽  
Nosheela Javed
Keyword(s):  
Stress Incontinence ◽  
Urge Incontinence ◽  
Surgical Repair ◽  
Maternal Child Health ◽  
Fistula Repair ◽  
Urogenital Fistula ◽  
Urine Examination ◽  
History Of ◽  
Patient’S History ◽  
Urinary Problems

Objective: Despite the successful fistula repair many patients may continue to complaint of persistence of symptoms in terms of frequency, urgency, urge incontinence and stress incontinence. To evaluate the association of various predictive factors with the outcome of surgical repair of urogenital fistula and todetermine the incidence and association of urinary problems post successful fistula repair. Methods: The retrospective analysis was conducted at Maternal Child Health, PIMS, Islamabad. It comprised data related to vesicovaginal fistula repair of patients from January 2008-June 2018. Various modalities were used to determine the underlying cause of these symptoms including patient’s history, examination, ultrasound, urine examination and urodynamic studies. Results: A total of 364 patients of urogenital fistula repair were reviewed, with an overall success in 318 (87.4%) cases.Primary surgical repair of vesicovaginal (90.0%), vesicouterine (86%), ureteric (100%) & ureterovaginal (98%) were more successful. Success rate was further decreased with the history of >1repair attempt of vesicovaginal (71.4%) & vesicouterine (66.5%) fistula. Among 318 successful fistulas repair patients, 78 (24.5%) had urinary problems post operatively. Out of these 78, 56.4% had stress incontinence, 41% infection and 2.6% urge incontinence. Conclusions: Urinary incontinence after fistula repair requires careful evaluation as the successful repair of a urogenital fistula can correct the fistula defect, but it might not make the patient dry.

Frequency of Success in Surgery of Vesicovaginal Fistula by Layered Closure with Graft Repair

2021 ◽  
Vol 15 (10) ◽  
pp. 3479-3481
Author(s):  
Anila Mujadid Qureshi ◽  
Azra Parveen Rajpar ◽  
Ishrat Saba Mari ◽  
Khalida Avesi ◽  
Kousar Fatima ◽  
...  
Keyword(s):  
Success Rate ◽  
Vesicovaginal Fistula ◽  
Case Series ◽  
University Hospital ◽  
Blue Dye ◽  
Urogenital Fistula ◽  
Vesicovaginal Fistulae ◽  
University Setting ◽  
Distressing Condition

Introduction: Vesicovaginal fistulae is abnormal communication between bladder and vagina that cause continous dribling of urine. It is physically, mentally and socially distressing condition. There are various approaches for surgeries of these urogenital fistulae with different success-rate that depend upon the experience of surgeon and surgical procedures. This study can help us to estimate the success rate of layered repair with graft in vaginal route to make stragedy to adopted in severe patient. Objective: To determine frequency of success in surgery on vesic-ovaginal fistulae by layered closured with graft repair procedures among patients admitted in Isra University. Setting: Obstetrics & Gynecology department in Isra university hospital Duration: 6 months from 10.2.2014 to 10.8.2014 Study Design: Case series Subject and methods: A total of 100 patients after having surgery for vesicovaginal fistula by layered closure with graft repair was included in this study. History and examination of all subjects were taken. The follow up visit was planned after 3 weeks of surgery. All women was questioned for recurrence of continuous urinary leakage and that without such symptoms proved by absence of leakage on methylene blue dye test was labeled as ‘success’. Results: - Frequency of success in surgery on vesic-ovaginal fistulae by layered closured with graft repair procedures was observed in 88% cases. Conclusion: The success rate of VVF repair by layered closured with graft repair procedures is high. It is concluded that obstetric urogenital fistula is a preventable condition. Keywords: Vesicovaginal fistulae, Layered closured, Graft repair, urogenital fistula

scholarly journals Increasing frequency of iatrogenic fistula- a new challenge

2018 ◽  
Vol 13 (2) ◽  
Author(s):  
Nasira Tasnim ◽  
Kauser Bangash ◽  
Oreekha Amin ◽  
Afshan Batool ◽  
Nosheela Javed
Keyword(s):  
Statistical Analysis ◽  
Caesarian Section ◽  
Study Data ◽  
Medical Sciences ◽  
Fistula Repair ◽  
Normal Delivery ◽  
Obstructed Labour ◽  
Urogenital Fistula ◽  
Approach Training ◽  
Caesarean Hysterectomy

Aims:  To determine the frequency of iatrogenic urogenital fistula in patients admitted for the repair of fistula in MCH, Pakistan Institute of Medical Sciences, Islamabad. Methods: The retrospective analysis was conducted at MCH PIMS, Islamabad. It comprised data related to patients having undergone urogenital fistula repair. Statistical analysis of the record was done using SPSS 21 software. Results:  Total 98 patients were analyzed. Themean age of patients was 31.6. Out of these, 67.3% of fistulas were attributed to iatrogenic causes while 32.7% were due to obstructed labour. The iatrogenic fistula included post instrumental delivery (5.1%), caesarian section (8.2%), caesarean hysterectomy (17.3%), hysterectomy (36.7%). The fistula caused by obstructed labour included post caesarian section (23.5%) and post normal delivery (9.2%). Conclusions: Our study data showed rising trend of iatrogenic fistula as compared to obstructed labour. This emphasizes the need of optimization of the surgical approach training along with improved obstetric skills, especially in the periphery. Keywords: iatrogenic fistula, obstetric skills, delivery

scholarly journals Doctor! Will I be dry? Factors determining recurrence after vesicovaginal fistula repair

2018 ◽  
Vol 13 (2) ◽  
Author(s):  
Aziz Abdullah ◽  
Sher Shah Syed ◽  
Nuzhat Farooqui ◽  
Sajjad Siddiqui
Keyword(s):  
Multivariate Analysis ◽  
Prognostic Factors ◽  
Confidence Interval ◽  
Odds Ratio ◽  
Vesicovaginal Fistula ◽  
Surgical Repair ◽  
Recurrence Risk ◽  
Fistula Repair ◽  
Careful Evaluation ◽  
Delayed Reconstruction

Aims: To evaluate various prognostic factors which determine outcome after surgical repair of VVF. Methods: A retrospective analysis of the record of 640 patients which underwent surgical repair of VVF during a period from Jan 2006 to June 2011. Multivariate analysis of the record was done using SPSS-19 software determining odds ratio with 95% confidence interval. Results: 640 patients underwent surgical repair of VVF. Overall success rate was 87.2%. Multivariate analysis determined that recurrence of VVF was significantly related to multiplicity (5 fold recurrence risk), pre-operative size of VVF (3 fold risk), secondary repair (3 fold risk) and etiology of the fistula (2 fold risk). Interposition of flap and delayed reconstruction was related to successful surgical outcome. Age, parity, route of repair and location of fistula were not significant prognostic factors for recurrence. Conclusions: Successful surgical repair of VVF require careful evaluation of various factors including number, size, previous attempts to surgical repair and etiology of VVF. One should opt for transabdominal route with delayed reconstruction and interposition of flap if above mentioned factors are present. 

scholarly journals Repair of Vesicovaginal FistulA: Experiene of 30 Cases and Analysis of Outcome Predictors

2020 ◽  
Vol 22 (2) ◽  
pp. 136-140
Author(s):  
Mrinmoy Biswas ◽  
Sharif Mohammad Wasim Uddin ◽  
Jasmine Sharifa ◽  
Sharmishtha Ghosa ◽  
AKM Musa Bhuiyan ◽  
...  
Keyword(s):  
Vesicovaginal Fistula ◽  
Primary Repair ◽  
Univariate Analysis ◽  
Predictors Of Outcome ◽  
Fistula Repair ◽  
Abdominal Approach ◽  
Ureteric Stenting ◽  
Chi Squared ◽  
History Of ◽  
Individual Variables

Objective:To find out the predictors of outcome of vesicovaginal fistula repair. Method: From 2013 t0 2015,thirty patients with vvf from different hospitals were managed surgically by different approach by single surgeons. During evaluation patients records,the duration of vvf,time of surgical repairs,site of fistulas, positionof fistulas,approach of repairs,ureteric stenting,and catheteruzation were considered. A univariate analysis was used to assess individual variables, by the chi - squared test andsignificant variables found in univariate analysis were considered in a mulivariate analysis. Result: Among 30 cases 90% were successful repair. We consider the following variables to be important risk factors like history of previous repair,timeof surgery,site of fistulas and surgical approach. Conclusion: Earlier correction of vvf, abdominal approach,high variety and primary repair has good outcome. Bangladesh Journal of Urology, Vol. 22, No. 2, July 2019 p.136-140

scholarly journals Surgical repair of Vesico-Vaginal: Vaginal route versus abdominal route.

2021 ◽  
Vol 28 (11) ◽  
pp. 1650-1655
Author(s):  
Abdul Qayoom Khuro ◽  
Illahi Bux Brohi ◽  
Muhammad Shahid Bhatti
Keyword(s):  
Success Rate ◽  
Sampling Technique ◽  
Cross Sectional Study ◽  
Medical Sciences ◽  
Vaginal Route ◽  
Fistula Repair ◽  
Cross Sectional ◽  
Abdominal Route ◽  
Expert Surgeon ◽  
Transvaginal Route

Objective: To determine outcomes and complications of vesico-vaginal fistula repair via vaginal and abdominal route. Study Design: Cross Sectional study. Setting: Department of Urology and Kidney Transplantation, Pir Abdul Qadir Institute of Medical Sciences Gambat. Period: January 2020 to December 2020. Material & Methods: Patients having vesicovaginal fistula irrespective of age and fulfilling our inclusion criteria were included in the study using non-probability consecutive sampling technique. Patients having very large fistula, fistula involving neck of urinary bladder, failure of previous operation, patients with malignancy or co-morbidities were excluded from the study. Vaginal and abdominal approaches were used for fistula repair depending upon the level of fistula. Those operated via vaginal route were kept in trans-vaginal group and those operated via abdominal route were assigned trans-abdominal group. Results: Total 35 cases were studied having age 16-45 years with mean age of 32.6 ± 4.2 years. Transvaginal fistula repair was done in 37.1% and transabdominal repair was done in 62.8% cases. Most common cause of VVF was previous gynecological surgery in 77% cases. Success rate was 100% in transvaginal fistula repair as compared to 95.4% success rate achieved in transabdominal repair of fistula. Conclusion: Trans abdominal and transvaginal route both are good approaches but Transvaginal route of fistula repair is associated with high success rate than transabdominal route with minimum complications and better outcomes but it needs expert surgeon.

scholarly journals Laproscopic intravesical vesicovaginal fistula repair after removal of an old vaginal drain tube-a rare case

2017 ◽  
Vol 6 (6) ◽  
pp. 2654
Author(s):  
Hafeez Rahman ◽  
Nikita Trehan ◽  
Dhruv P. Gohil ◽  
Ajay Aggarwal
Keyword(s):  
Rare Case ◽  
Vesicovaginal Fistula ◽  
Direct Access ◽  
Drain Tube ◽  
Fistula Repair ◽  
Vaginal Repair ◽  
The Past ◽  
Standard Laparoscopy ◽  
History Of ◽  
Good Exposure

The management of vesicovaginal fistula is difficult and challenging We are presenting a rare case of a 24-year-old unmarried girl with history of vaginoplasty and multiple surgeries done in the past, with a vaginal drain tube kept for 12 years and a Vesicovaginal fistula at the bladder trigone. Patient was successfully treated with a laproscopic Intravesical vesicovaginal Fistula repair. As advances in understanding the etiology of VVF have been made, the laproscopic approach has become the gold standard. Laparoscopy allows an excellent view, good exposure of pelvic structures, provides direct access to the fistula and for repair of complex VVF that may not be amenable to vaginal repair.

scholarly journals Outcome of Vesicovaginal Fistula Repair at Urology Department STH Swat

2020 ◽  
Vol 10 (2) ◽  
Author(s):  
Nizamuddin . ◽  
Fazal Elahi ◽  
Mumtaz Ali ◽  
Fazli Akbar ◽  
Mohammad Hussain ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Success Rate ◽  
Vesicovaginal Fistula ◽  
Abdominal Hysterectomy ◽  
Teaching Hospitals ◽  
Fistula Repair ◽  
Obstructed Labour ◽  
Urinary Tract Symptoms ◽  
Tract Infections ◽  
Lower Urinary

Background: Vesicovaginal fistula is an abnormal passage between the bladder and the vagina , which leads to continuous , involuntary loss of urine through the vagina. It is the most usual type of acquired genitourinary fistulas.Objective: To determine outcomes of vesicovaginal fistula repair at Urology Department, Saidu Teaching Hospital, Swat.Material and Methods: This descriptive study was conducted in Department of Urology, Saidu Group of Teaching Hospitals, Swat from September, 2016 to February, 2019. Patients with age group of 25-65 years, diagnosed with VVF were repaired either through abdominal or vaginal route. These patients were prospectively analysed and the demographic profile, route of surgery and outcomes were noted down.Results: A total of 58 patients were included in the study. The causes were obstructed labour in 26 patients, post-operative trans abdominal hysterectomy and caesarean section in 24 and 6 cases respectively. There was 100% success rate in abdominal repairs as compared to combined approach. Among the post-operative complications, bladder storage dysfunction was on the top, followed by urinary tract infections and wound infections.Conclusion: The most common cause of VVF was prolonged obstructed labour. Overall, the success rate was 96.5%. Irritative lower urinary tract symptoms were most commonly observed post operatively.

scholarly journals Incidence of Urinary Problems Post Successful Fistula Repair

2018 ◽  
Vol 13 (2) ◽  
pp. 23-26
Author(s):  
Nasira Tasnim ◽  
Kauser Bangash ◽  
Oreekah Amin ◽  
Afsan Batool
Keyword(s):  
Stress Incontinence ◽  
Urge Incontinence ◽  
Previous History ◽  
Maternal Child Health ◽  
Fistula Repair ◽  
Urogenital Fistula ◽  
Urine Examination ◽  
History Of ◽  
Patient’S History ◽  
Urinary Problems

Aims:  The aim was to determine the incidence and association of urinary problems post successful fistula repair. Methods: The retrospective analysis was conducted at Maternal Child Health Pakistan Institute of Medical Sciences, Islamabad, and comprised data related to patients having undergone vesicovaginal fistula repair from January 2008 to June 2018. Various modalities were used to determine the underlying cause of these symptoms including patient’s history, examination, ultrasound, urine examination and urodynamic studies. Statistical analysis of the record was done using SPSS 21 software. Results:  Among total 318 successful fistulas repair patients, 78 (24.5%) had urinary problems post operatively. Out of these 78, 56.4% had stress incontinence, 41% infection and 2.6% urge incontinence.13.6% of the stress incontinence was due to sphincter weakness. Urge incontinence was found to be due to detrusor instability. These post-operative urinary complaints were significantly associated with the repair of vesicovaginal (31.3%), urethral (23.1%) and vesicouterine (15.7%) fistula compared to those involving ureter(p 0.04). No significant association was found between the incidence of post-operative urinary complaints and previous history of surgical repair, parity, fistula size and duration of fistula. Conclusions: Urinary incontinence after fistula repair requires careful evaluation as the successful repair of a urogenital fistula can correct the fistula defect, but it might not make the patient dry. Moreover, performing further continence surgery may exacerbate the condition in some cases.

scholarly journals Iatrogenic Genitourinary Fistula: Changing Trends

2018 ◽  
Vol 13 (2) ◽  
Author(s):  
T Pradhan ◽  
A Agrawal ◽  
MC Regmi
Keyword(s):  
Decision Making ◽  
Retrospective Study ◽  
Work Environment ◽  
Vesicovaginal Fistula ◽  
Emergency Caesarean Section ◽  
Fistula Repair ◽  
Genitourinary Fistula ◽  
Changing Trends ◽  
Increasing Trend ◽  
History Of

Aims: To study the frequency of iatrogenic cause amongst the surgery done for genitourinary fistula and to study the type and cause of iatrogenic genitourinary fistula. Methods: This is a 5 year retrospective study analyses 73 iatrogenic fistulas from 217 women undergoing surgery for genitourinary fistula repair from year 2013 to 2018 on going. The analysis considers frequency and characteristics of type of fistula. Results: Out of 217 genitourinary fistula 73(33.6%) were iatrogenic. Vaginal vault fistulas were 54.7% followed by ureteric fistula 32.8%, vesicovaginal fistula 10.9% and there were 2 iatrogenic RVF. The frequency of surgeries for iatrogenic fistula were found to be in increasing trend towards current years and 83.5% of the iatrogenic fistula were found with history of hysterectomy followed by emergency caesarean section 16.4%.  Conclusions: Women undergoing hysterectomy were under risk for iatrogenic fistula. Optimum work environment is important to reduce surgical error during procedures. Operating training should be emphasized on optimal surgical skills, decision making.

Sign in / Sign up

Export Citation Format

Share Document