VESICOVAGINAL FISTULA REPAIR THROUGH VAGINAL APPROACH

Abstract

Abstract

Objectives:  To evaluate the outcome of trans-vaginal repair of vesico-vaginal fistula through vaginal appro-ach.

Study Design:  Prospective study.

Material and Methods:  This study was carried out in Department of Urology, Shaikh Zayed Postgraduate Medical Institute and National institute of Kidney Dis-eases, Lahore for the period extending from April 2009 to April 2014. Total 17 patients were included in the study. History, physical examination and findings on investigations were reviewed. In all patients cysto-scopy and vaginal examination was performed to see fistula site and ureteral orfices. Then trans-vaginal repair was done in all cases.

Results:  VVF repair was performed on 17 patients

Ashraf S.¹

Professor and Head of Department

Kidney Transplant Unit Sheikh Zayed Hospital, Lahore

Hussain N.²

Assistant Professor

Kidney Transplant Unit Sheikh Zayed Hospital, Lahore

Ibrahim M. N.³

Senior Registrar

Kidney Transplant Unit Sheikh Zayed Hospital, Lahore

Rahim J.⁴

Assistant Professor

Department of Urology Sheikh Zayed Hospital, Lahore

aging 25 to 45 years (mean 35.83 ± 7.37 years). The symptoms preceded for a period of 3 months to 8 years. The cause was gynecological hysterectomy 8 (47.05%), obstetric C-section 7 (41.17%) and obstruc-ted labor 2(11.76%). In three of our patients VVF was previously repaired trans-abdominally. On cystoscopy no patients had more than one fistula. In two (11.76%) patients fistula was supratrigonal. The average size of fistula was 2.05 cm, detail of fistula site and size is given in table. One patient had leakage on second post op day that was managed with change of Foleys cathe-ter. Successful repair was achieved in all patients and no patient required second attempt. No ureteric injury and other complications were observed.

Conclusion:  Trans-vaginal repair of VVF avoid lapa-rotomy and bladder bisection. It has reduced hospital stay and morbidity.

Key Words:  Urinary bladder, vagina, fistula, VVF.