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Transvaginal repair of vesicovaginal fistula: the standard of care: ten years experience
Author(s):
1. Khalid Farouk: Department of Urology and Kidney Transplantation, Foundation University Medical College/ Fauji Foundation Hospital Rawalpindi, Pakistan
2. Asher Masood: Department of Urology and Kidney Transplantation, Foundation University Medical College/ Fauji Foundation Hospital Rawalpindi, Pakistan
3. Imran Zahoor Khan: Department of Urology and Kidney Transplantation, Foundation University Medical College/ Fauji Foundation Hospital Rawalpindi, Pakistan
4. Riffat Najeeb: Department of Obstetrics and Gynaecology, Watim Medical and Dental College, Rawalpindi. Pakistan
5. Ishtiaq Ahmed: Department of Urology and Kidney Transplantation, Foundation University Medical College/ Fauji Foundation Hospital Rawalpindi, Pakistan
6. Syed Ali Murtaza: Department of Urology and Kidney Transplantation, Foundation University Medical College/ Fauji Foundation Hospital Rawalpindi, Pakistan
Abstract:
Background: Vesicovaginal fistula (VVF) is a debilitating condition leaving the effected female incontinent of urine. There has been a shift in the etiology of VVF in developing nations where hysterectomy is becoming a leading cause of VVF. Objective: To share our experience of transvaginal repair of VVF using a modified Latzko technique and evaluate various factors for a successful repair. Study type, settings & duration: This retrospective study was carried out at the Department of Urology and Kidney Transplantation, Fauji Foundation Hospital, Rawalpindi from March 2010, to August 2020. Methodology: Data were collected from patients who underwent transvaginal repair of VVF by a modified Latzko technique. Data consisting of multiple variables was analyzed using SPSS version 21. For qualitative data, percentages and frequencies were given and for quantitative data mean±SD were used. A comparison of two quantitative variables was done by using an independent t-test. For categorical variables, the chi-Square test was used. The p value =0.05 was taken as statistically significant. Results: A record of 144 patients was analyzed. Multivariate analysis revealed a statistically significant relationship between etiology (p-value 0.000), location (p-value 0.002) and size of VVF (p-value 0.000) and a successful repair, while number (p-value = 0.71) and VVF with a previous history of repair (p-value = 0.83) were insignificant factors. Success was observed in 98.6% while recurrence occurred in 1.4%. Conclusion: Transvaginal repair of Vesicovaginal fistula using a modified Latzko technique can be carried out in all vesicovaginal fistulae whether primary or recurrent irrespective of its aetiology, size, site and number. It has a high success rate and minimal complications.
Page(s): 70-76
DOI: DOI not available
Published: Journal: Pakistan Journal of Medical Research, Volume: 62, Issue: 2, Year: 2023
Keywords:
Urinary incontinence , Vesicovaginal fistula , Hysterectomy , Obstructed labour , transvaginal repair
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