Comparison of Vesicovaginal Fistula Repair with Omental transposition versus perivesical fat emplacement.

Abstract

Objectives: To compare the outcome of Vesicovaginal fistula repair by omental transposition and perivesical fat emplacement in terms of recurrence and maximum bladder capacity. Study Design: Randomized control trial. Setting: Urology department of Peoples University Hospital Nawabshah, Sindh, Pakistan. Period: From January 2018 to December 2018. Material & Method: Overall 40 patients with VVF were added in the research, split into two identical groups, each consisting of 20. In group 1, omental transposition and in group 2, perivesical fat emplacement was done. Adult female patients with Vesicovaginal fistula, resulting from obstetrical and as a complication of surgery was included. This was confirmed by physical examination, IVU, pelvic computerized tomography scan with contrast, retrograde uretherocystogram, ultrasound KUB and cystoscopy. Exclusion criteria were Patients with systemic illness like diabetes mellitus, chronic renal failure and chronic liver disease etc, immunosuppressant therapy like: steroids intake, patient’s undergone irradiation of the pelvis due to any malignant disease. Follow up after 6, 12 and 24 weeks, all the patients were assessed for recurrence. The complications like wound infections, urgency, urge incontinence and paralytic ileus were also noted. The data was collected in a specially designed proforma. Results: In this study 40 patients fulfilling the inclusion criteria were included, 20 patients in each group. The success rate was 95 %( 19 /20) in group 1, only one case had recurrence. While in group 2 all the cases were successful. Chi square analysis was employed for comparison of adequacy of both the techniques, the P value was found to be 0.311 which suggests that the difference between the efficacies was not statistically significant. Conclusion: It is concluded that both the techniques of Vesicovaginal fistula repair, either with omental transposition or perivesical fat emplacement are equally good in terms of recurrence and maximum bladder capacity.