experience of trans-abdominal repair of vesico-vaginal and uretero-vaginal fistulae

ABSTRACT

To assess the success rate of trans-abdominal repair of vesico-Vaginal fistula. This prospective descriptive study was conducted in the Departments of Surgery, Gynaecology and Urology, Ghulam Mohammad Mahar Medical College Hospital, Sukkur, Pakistan from August 2009 to July 2012. A total 27 patients of vesicovaginal fistula [VVF] and Uretero-Vaginal fistulae were included in the study. All patients had supra-trigonal multiple or single VVF were repaired by the abdominal approach. The outcome of the procedure and post-operative complications were recorded. Thirteen patients had single Supra-trigonal, three had multiple VVF. Three had vesico-Uterine and four had uretero-vaginal fistulae. All were operated by abdominal approach successfully. Pelvic surgery [abdominal hystrectomy /LSCS] was the major cause of VVF, accounting for 66.66 %[18 Patients], while in remaining 33.33% [9 patients] the obstructed and prolonged labor were the cause. All fistulae healed successfully with minor leaking in 2 [7.4%] patients which settled spontaneously. One patient developed post-operative adhesions [small bowel obstruction] and was explored and adhesiolysis was done. Three [11.11%] patients developed post-operative wound infection and healed by dressing. Trans abdominal is an excellent approach for supra-trigonal, vesico-uterine and uretero-vaginal types of fistulae