Surgical management of vesicovaginal fistula repair: Our experience.
Objectives: The results of our study would generate useful baseline database which would help the surgeons to manage these fistulae and their related complications properly. Study Design: Non-randomized Clinical Control Trial study. Setting: Department of Urology, Bahawal Victoria Hospital, Bahawalpur and Shahida Islam Medical College, Lodhran. Period: From July 2015 to June 2016. Material & Methods: Total 150 women with vesico-vaginal fistula (VVF) on cystoscopy of either age were selected. Patients with history of recurrence of fistula, multiple fistulae, radiation and severe vaginal scarring were excluded. The transvaginal management was approached in cases of simple fistula, VVF located at trigone of bladder while transabdominal route was preferred when the fistula site could not be easily accessed per vagina, when VVF was above trigone or when the VVF was complex. These patients were followed for 6 weeks at 2 week time interval. Results: Age range in this study was from 20 to 60 years with mean age of 38.18 ± 10.64 years. Majority of patients were (41.72%) with medium sized fistula. In 92 patients, abdominal repair was done while in 52 patients vaginal repair was done. Unsuccessful repair was seen in 14 (9.33%), infection in 25 (16.67%) and recurrent fistula formation in 21 (14.0%) patients. Conclusion: This study concluded that the frequency of unsuccessful repair and recurrent fistula is more after vaginal repair compared to abdominal repair while infection rate was more after abdominal repair.