Vesicovaginal fistula: a challenge for women in developing countries

ABSTRACT

An experience of 19 cases of vesiovaginal fistula [VVF] in Gynae unit III at Civil Hospital, Karachi during a period of 30 months is presented. The purpose of this study was to determine the etiology of VVF and the results of repair and how to prevent the causes of fistula formation. The majority [89.48%] of fistulae were caused by ischaemic necrosis resulting from obstetrical trauma. The flap splitting method of repair was used and most of the fistulae were approached per vaginum. Absorbable synthetic suture [vicryl no 2/0] was used for closure with good results. None of our cases needed interposition of tissues or urinary diversion. Repair was successful in 62.5% cases. Measures to prevent VVF formation are suggested because it is an avoidable condition as has been effectively eliminated from industrialized countries