Repair of Vesicovaginal Fistulae

Abstract

Objectives:  To evaluate outcome of surgical repair of VVF with transabdominal and transvaginal appro-aches.

Design and Setting of Study:  It was a prospective study, conducted in department of surgery Bahawal Victoria Hospital Bahawalpur from Jan 2005 to Dec 2009.

Materials and Methods:  All consecutive patients with VVF irrespective of age and etiology were inclu-ded in this study. Patients with VVF and involvement of bladder neck were excluded. These patients were analysed for results of surgical repair by trans-abdo-minal and transvaginal approaches.

Results:  This study included 20 patients with age range between 20 - 58 years. Etiology of VVF was observed to be trans-abdominal hysterectomy in 10 patients, transvaginal hysterectomy in 01 patient, post C-section 01 patient and obstructed prolonged labour in 08 patients. Transabdominal repair was done in 12 patients while 08 patients have undergone transvaginal repair after investigations and evaluation. We achieved 91.67% success with transabdominal repair of VVF while 100% success with transvaginal repair.

Conclusions:  It is best to wait for at least 03 months after occurrence of VVF, so that inflammatory chan-ges due to previous surgery / birth trauma may have settled completely before attempting at repair. Best results are achieved at first attempt of repair. Both approaches of surgical repair of VVF have good results.

Key words:  Vesicovaginal Fistula, Transabdominal Rewpair, Transvaginal Repair.