Comparison of the Outcome of Vesicovaginal Fistula Repair with Omental Transposition and Peri-vesical Fat Emplacement in Terms of Recurrence

Abstract

Background: Persistence of urinary incontinence after an attempted vesicovaginal fistula (VVF) repair leads to frustration for the patient as well as for the surgeon. Optimal approach for the surgery, stage and use of additional measures to strengthen VVF repair is controversial. However, it has been found that interposition of some sort of tissue has provided more promising results. Objective: To compare the outcome of Vesicovaginal fistula repair by omental transposition and peri-vesical fat emplacement in terms of recurrence and maximum bladder capacity. Study Design: Randomized control trail. Settings: Urology department of Lahore General Hospital, Lahore Pakistan. Duration: Study period was 1 year. Methodology: 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, peri-vesical fat emplacement was done. 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 19/20 (95%) in Group-1, only one case had recurrence. While in group 2 all the cases were successful. Conclusion: It is concluded that both the techniques of Vesicovaginal fistula repair, either with omental transposition or peri-vesical fat emplacement are equally good in terms of recurrence and maximum bladder capacity.