VESICO-VAGINAL FISTULA REPAIR

UROLOGIST’S EXPERIENCE AT BAHAWALPUR.

Abstract

Objectives: To evaluate outcome of surgical repair of VVF with transabdominal and transvaginal
approaches. Design of study: Prospective study. Setting: Depart of Urology Bahawal Victoria Hospital Bahawalpur.
Period: Jan 1999 to Dec 2004. Materials & Methods: All consecutive patients with VVF irrespective of age and
aetiology were included in this study. Patients with very large VVF and involvement of bladder neck were excluded.
These patients were analysed for results of surgical repair by trans-abdominal and transvaginal approaches. Results
This study included 26 patients with age range between 20-48 years (mean age of 34 years). Etiology of VVF was
observed to be transabdominal hysterectomy in 15 patients, transvaginal hysterectomy in one patient. While obstructed
prolonged labour caused VVF in 10 patients. Transabdominal repair was done in 18 patients while 08 patients have
undergone transvaginal repair after investigations and evaluation. We achieved 94.45% success with transabdominal
repair of VVF while 100% success with transvaginal repair. Conclusions:The etiology of this disease is preventable.
It is best to wait for at least 03 months after occurrence of VVF, so that inflammatory changes due to previous surgery
/birth trauma may have settled completely before attempting at repair. Best resultrs are achieved at first attempt of
repair. Both approaches of surgical repair of VVF have good results.