Abstract:
Objective: To present the efficacy and complications of vesicovaginal fistulae repair in our setting. Place and duration of the study: Surgical unit-III, Bolan Medical Complex Hospital, Akram Hospital Zarghoon Road, Quetta and Uhad Charity Hospital Quetta from April 1999 to March 2003. Patients and methods: A total of 32 patients of vesicovaginal fistulae resulting from causes other than malignancies and pelvic radiations were included in the study. Patients were divided in to two groups on the basis of the site of the fistula and the method of repair. Group-I comprised of 18 patients who had typeµ and low type-I fistulae and were operated by vaginal approach while group-µ consisted of 14 patients who had type-III and high type-I fistulae and were operated by abdominal approach. Patients of both groups were discharged to go home after 5-7 days postoperatively. Postoperative follow up was carried out at out door on weekly basis for two months. Results: The cause of vesico-vaginal fistulae was obstetrical in 28 (87.5%) and gynaecological (hysterectomy) in 4 (12.5%) patients. Trans-vaginal repair of fistula was successful in 16 (88.9%) patients at first operation while in abdominal approach the cure rate was 100%. However preoperative bleeding requiring blood transfusion occurred in 5 (35.7%) patients of group-II. Another one patient in this group developed wound infection. Dysuria/urinary frequency and hematuria persisted for few days postoperatively in some patients of both groups. Urinary stress incontinence was present postoperatively in 5(27.7%) and 3 (21.4%) patients of group-I and group-11 respectively but it subsided in two months time in all except 2 (11.1%) patients of group-I. Conclusion: Birth trauma is still a major cause of vesicovaginal fistula in our region Improvement in health services and socio-cultural status can help to reduce the incidence of this demoralize in injury. Once occurred VVF, can successfully be repaired by strictly adhering to principles of; a tension free repair, adequate blood supply, prevention of infection and adequate postoperative bladder drainage.
Page(s):
261-266
DOI:
DOI not available
Published:
Journal: Professional Medical Journal, Volume: 11, Issue: 3, Year: 2004