Profile and repair success of vesico-vaginal fistula in Lahore

To describe the profile of patients with vesico-vaginal fistula [VVF] and success rate of the surgery. Design: Descriptive study. Place and Duration of Study: Sir Ganga Ram Hospital and Ghurki Trust Hospital, Lahore, between 1998 and 2002. Patients and All patients diagnosed as cases of vesico-vaginal fistula were included in the study. Those patients, who had previous unsuccessful surgery for vesico-vaginal repair, whether done in the hospital or outside, were also included. Their demographic profile and repair success was determined. Out of 2570 gynaecological admissions, 14 women had vesico-vaginal fistulae showing the prevalence of 0.55 / 100 gynaecological admissions. Obstetrical cause was found in 71.4% of the cases. The mean age of the patients was 34.85 +/- 6.3 years [range 25-45] with parity varying from 0-9 [median 4]. The position of majority of the fistulas [57.2%] was high [vault, juxta-cervical]. Success rate of the surgery in the study was 85.7%. Majority of the repairs [78.6%] were done through vaginal route. The most common cause of vesico-vaginal fistula in this study was obstetrical, either prolonged labour or caesarean hysterectomy. Although the success rate of repair was high, yet the attempt should be focussed on prevention