scholarly journals Vesico-vaginal fistula: A clinical study

2019 ◽  
Vol 31 (1) ◽  
Author(s):  
S.V. Krishna Reddy ◽  
Ahammad Basha Shaik
Keyword(s):  
Laparoscopic Approach ◽  
Abdominal Hysterectomy ◽  
Timing Of Surgery ◽  
Vaginal Fistula ◽  
Success Rates ◽  
Vaginal Repair ◽  
Abdominal Approach ◽  
Negative Effect ◽  
Vesico Vaginal Fistula

In a retrospective study, the records of 34 women with a mean ± SD age of the patients was 36.62 ± 9.02 years were assessed; 32.35% of the vesico-vaginal Fistula (VVF) occurred after abdominal hysterectomy, 11.77% after Caesarean section, 32.35% after difficult vaginal delivery and 23.53% after instrumental delivery. Six women (17.64%) had a previous failed repair. The duration (mean ± SD) of the VVF was 5.68 ± 1.59 months. Of the 34 VVF patients, 20 (58.82%) were Mid-Vaginal VVF, 8 (23.53%) were Circumferential VVF, 3 (8.82%) were Juxta cervical VVF and 3 (8.82%) were Juxta Urethral VVF. An abdominal approach was used in 21 cases (61.76%), vaginal repair was contemplated in 8 (23.53%) cases and Laparoscopic in 5 (14.71%). At a mean duration of follow-up was 33.06 ± 1.72 months and the VVF was cured in 28 (82.4%) patients. Only previous intervention and timing of surgery (P=0.004) and surgical approach (P=0.02) maintained significance in our study. An abdominal/ Laparoscopic approach seems to give superior results. Previous failed repair had a significant negative effect on success. A late repair (≥6 months) is associated with higher success rates.

scholarly journals Vesico-Vaginal Fistula Repair Through Abdominal Approach

KYAMC Journal ◽  
2020 ◽  
Vol 11 (3) ◽  
pp. 129-132
Author(s):  
Hafiz Al Asad ◽  
Asif Yazdani ◽  
Zulfia Zinat Chowdhury ◽  
Muhammad Faruk Hussain ◽  
AKM Shahadat Hossaion ◽  
...  
Keyword(s):  
Wound Infection ◽  
Operative Time ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Pelvic Surgery ◽  
Vaginal Fistula ◽  
Abdominal Approach ◽  
History Of ◽  
Vesico Vaginal Fistula

Background: Vesico-Vaginal Fistula (VVF) is a major cause for concern in many developing countries with significant morbidity. Among the different techniques abdominal approach of VVF repair is important one. Objective: To find out the outcome of VVF repair by abdominal approach. Materials and Methods: It is a prospective study. Twenty-three patients with VVF were operated with abdominal approach from the period of January 2016 to January 2019. Age of patients, co-morbidities, cause, size and location of VVF were evaluated. Then abdominal approach of VVF repair was done. Operative time and need of blood transfusion were encountered. Post operative (POD) urine leakage, wound infection or other complications were enlisted. Patients were discharged with keeping urethral catheter for 14 days. Follow up was done after 1 and 3 month and in each follow up history and physical examination was done. All collected data were evaluated. Results: Mean age of the patient was 40 years. Among the 23 patients 12 (52%) patients had history of total abdominal hysterectomy, 9 had history of caesarian section and 2 cases had history of pelvic surgery. VVF repair was done at least 12 weeks after its occurrence. Operative time ranged from 90 minutes to 150 minutes. In the immediate POD no obvious complications were noted except one patient developed wound infection on 7th POD. Follow-up done as per schedule and no recurrence of VVF noted. Conclusion: VVF repair through abdominal approach is a feasible, safe and effective technique if performed meticulously. KYAMC Journal Vol. 11, No.-3, October 2020, Page 129-132

scholarly journals Repair of Vesicovaginal Fistula: Experience of 30 Cases and Analysis of Outcome Predictors

2019 ◽  
Vol 13 (2) ◽  
pp. 85-88
Author(s):  
Mrinmoy Biswas ◽  
Sharif Mohammad Wasim Uddin ◽  
Jasmine Sharifa ◽  
Sharmishtha Ghosal ◽  
Dilruba Zeba
Keyword(s):  
Vesicovaginal Fistula ◽  
Medical Condition ◽  
Primary Repair ◽  
Abdominal Hysterectomy ◽  
Success Rates ◽  
Abdominal Approach ◽  
Successful Technique ◽  
Genital Fistula ◽  
Female Genital

Female genital fistula is a serious medical condition in which a perforation develops most commonly between bladder and vagina (VVF). Although the majority of genitourinary fistulas can be closed surgically, the successful closure depends on many factors. In this retrospective study, the records of 30 women with a mean age of 23.8 years were assessed; 13% of the VVF occurred after abdominal hysterectomy, 67% after Caesarean section, and 20% after difficult vaginal delivery. Six (20%) women had previous repair. The median duration of the VVF was 5.9 months. Of the 30 patients of VVF, 24 were high and 6 were low. Twenty seven had single fistula opening and 3 had two fistulous openings. An abdominal approach was used in 24 patients and vaginal approach in 6 patients. At a mean follow up of 24 months, the VVF was cured in 90% patients. In conclusion, surgical correction of the VVF is more successful when done earlier, probably in the first 6 months. Abdominal approach seems to be more successful technique and recurrent VVF being associated with lower success rates than primary repair. High variety also has good result. Faridpur Med. Coll. J. Jul 2018;13(2): 85-88

Vesico-vaginal fistula presenting as overactive bladder in a case of Gellhorn pessary for vault prolapse

2021 ◽  
Vol 14 (3) ◽  
pp. e240331
Author(s):  
Mamta Bhat ◽  
Santanu Acharya ◽  
Wael Agur
Keyword(s):  
Overactive Bladder ◽  
Initial Period ◽  
Vaginal Fistula ◽  
Lifestyle Modifications ◽  
Vault Prolapse ◽  
Indwelling Catheter ◽  
Wound Debridement ◽  
Gellhorn Pessary ◽  
Vesico Vaginal Fistula

An 81-year-old woman with early dementia was on a regular follow-up for change of Gellhorn pessary every 6 months for vault prolapse. She presented with frequency and urgency for 10 months duration 5 years into conservative management. Her symptoms did not improve on anticholinergics and lifestyle modifications. She underwent an opportunistic change of pessary under general anaesthesia coincidental to scalp wound debridement. On removal of the pessary, a gush of urine was noted followed by confirmation of a large vesico-vaginal fistula (VVF). In the initial period of follow-up, she was reviewed by the urogynaecology team and considered to be a poor surgical candidate for a major surgical procedure and was offered conservative measures with incontinence pads and possible indwelling catheter. Serious complications like fistulae can still occur despite well-managed pessary treatment. Earlier presentation with overactive bladder symptoms masked the VVF resulting in delayed diagnosis.

Abdominal operations for stress incontinence

1998 ◽  
Vol 65 (1) ◽  
pp. 19-23
Author(s):  
S. Caschetto ◽  
V. Leanza ◽  
S. Di Leo
Keyword(s):  
Stress Incontinence ◽  
Surgical Procedures ◽  
Type I ◽  
Burch Colposuspension ◽  
Vaginal Repair ◽  
Genuine Stress Incontinence ◽  
Abdominal Approach ◽  
Retropubic Space ◽  
Abdominal Operations

Among the surgical procedures with abdominal approach (Burch colposuspension, Marshall-Marchetti-Krantz operation, Richardson paravaginal repair) used to correct genuine stress incontinence (GSI), the Burch colposuspension is both easy to perform and very effective. The purpose of the operation is to reposition the cervicourethral complex in a fixed retropubic space. Since anterior replacement of the vaginal axis may cause iatrogenic enterocele or increase a posterior cystocele or a previous rectocele, other complementary operations (Douglas obliteration, anterior or posterior vaginal repair) are necessary. The authors report that in 256 patients with type I and II genuine stress incontinence, the recovery rate after Burch colposuspension associated with gynecological procedures has been 81.25% in a 1 to 5-year follow-up.

SUCCESSFUL TREATMENT OF VESICO-VAGINAL FISTULA THROUGH THE ABDOMINAL APPROACH: A 24-YEAR EXPERIENCE

2006 ◽  
Vol 5 (2) ◽  
pp. 193
Author(s):  
M. Mancini ◽  
R. Boscolo Berto ◽  
F. Gottardo ◽  
F. Dal Moro ◽  
F. Pagano ◽  
...  
Keyword(s):  
Successful Treatment ◽  
Vaginal Fistula ◽  
Abdominal Approach ◽  
Vesico Vaginal Fistula

Which procedure for incontinence?

2005 ◽  
Vol 11 (1) ◽  
pp. 23-27 ◽  
Author(s):  
Nicholas Christofi ◽  
Andrew Hextall
Keyword(s):  
Gold Standard ◽  
Multidisciplinary Approach ◽  
Standard Procedure ◽  
Transobturator Tape ◽  
Similar Efficacy ◽  
Success Rates ◽  
Transverse Incision ◽  
Abdominal Approach

Approximately 16–29% of women will complain of incontinence at the menopause. A multidisciplinary approach to treatment is essential and surgery is usually reserved for women who have failed to improve sufficiently with conservative measures, such as pelvic floor exercises. The Burch colposuspension remains the 'gold standard' procedure for stress urinary incontinence, against which all newer procedures are compared. It is normally carried out under general anaesthesia and requires an abdominal approach, most often by a low transverse incision. Tension-free vaginal tape (TVT) is the most popular procedure at present and has largely replaced colposuspension in many units. However, there are concerns about both its long-term safety and the lack of data on efficacy beyond the first few years. Initial reports of transobturator tape suggest that it may have a similar efficacy to TVT but with a lower rate of serious complications; however, large comparative studies and longterm follow-up data are currently unavailable. Collagen and silicone injected around the urethra can be used in a selected group of patients under local anaesthetic but the success rates are disappointingly low.

scholarly journals Surgical Outcome of Vesico-Vaginal Fistula (VVF) after Repair: Experience of 51 Cases in a Teaching Hospital of Dhaka City

2019 ◽  
Vol 5 (1) ◽  
pp. 29-32
Author(s):  
Shimul Akter ◽  
Fouzia Mujib ◽  
Mohammed Masudur Rahman ◽  
Dewan Shahida Banu ◽  
Taslima Begum ◽  
...  
Keyword(s):  
Surgical Outcomes ◽  
Surgical Outcome ◽  
Abdominal Hysterectomy ◽  
Cross Sectional Study ◽  
Medical College Hospital ◽  
Vaginal Fistula ◽  
College Hospital ◽  
Cross Sectional ◽  
Medical College ◽  
Vesico Vaginal Fistula

Background: Surgical management of vesico-vaginal fistula is very crucial regarding the outcomes among the women. Objectives: The purpose of the present study was to see the surgical outcomes of vesico-vaginal fistula. Methodology: This cross-sectional study was carried out from July 2013 to December 2013 for a period of 6 months in the National Fistula Centre in the Department of Obstetrics & Gynaecology at Dhaka Medical College Hospital (DMCH), Dhaka, Bangladesh. All patients who underwent surgical repair for iatrogenic VVF in National Fistula Centre of the department of Obstetrics and Gynaecology of Dhaka Medical College Hospital were included in this study. Patients who got themselves admitted to Obstetrics & Gynaecology department of DMCH with the complaints of fistula. An interview usually lasted for an hour. The entire selected patients were interviewed for detailed history. Thorough physical examination was done. The surgical outcomes were recorded among the women. Result: A total number of 51 cases of VVF were recruited for this study. The mean age was 46.02 (±SD 6.104) years. Regarding the causes of iatrogenic vesico-vaginal fistula most of the cases (88.2%) were abdominal hysterectomy. In 4(7.8%) patients lower segment caesarean section caused the situation. Vaginal hysterectomy was responsible for 3.9% (2/51) cases of iatrogenic VVF. In more than 90% cases (46/51) the surgical outcome was successful; while in 5 patients’ fistula recurred 5 to 7 days following surgery. They were treated by re-operation later on. Conclusion: In conclusion abdominal hysterectomy is the most common cause of iatrogenic vesico-vaginal fistula with a very good surgical outcomes. Journal of National Institute of Neurosciences Bangladesh, 2019;5(1): 29-32

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