Vesicovaginal Fistula, Causative Factors and Outcome of Surgical Management: An Experience at PMC/Allied Hospital Faisalabad

Abstract

Objectives: To assess the causative factors and outcome of surgical management of Vesicovaginal fistula (VVF) in our set up. Duration & Design of Study: Retrospective descriptional study from January 2008 to June 2012 conducted at Department of Urology PMC/Allied Hospital Faisalabad. Methodology: All patients with VVF who presented in our out patient department and underwent surgical repair in our department were included in this study. The records of patients were reviewed and data was entered in a structured proforma and analyzed. After history, physical examination, relevant investigations, IVU, Cystoscopy and vaginoscopy, patients were divided into two groups. Patients with supratrigonal fistula were operated through abdominal approach and those with infratrigonal fistula were operated through vaginal approach. The outcome of surgical procedures and post operative complications were noted. Results: This study included 68 patients. In 42 (61.76%) patients, cause of VVF was iatrogenic injury during hysterectomy, and 26 (38.24%) patients developed VVF due to obstetric causes. Fifty patients (73.53%) had supratrigonal fistula and eighteen patients (26.47%) were having trigonal or subtrigonal fistula. We achieved 90% and 83.33% success rate with abdominal and vaginal repair respectively. Conclusion: The most common cause of VVF is iatrogenic injury during hysterectomy. Both approaches of surgical repair had almost equally good results.