Comparative analysis of transvaginal approach and transabdominal approach for vesicovaginal fistula / 中华泌尿外科杂志

ABSTRACT

Objective To compare the efficacy of transvaginal and transabdominal repair surgery for the treatment of vesicovaginal fistula(VVF).Methods The data of 39 patients undertaken VVF repair in our department between January 2005 and December 2016 was retrospectively reviewed.The patients aged 19 to 69 years (median 45 years),and the median duration of the condition was 22 months (range1 month to 20 years).The etiologies were all iatrogenic injuries.Thirty-nine patients underwent a total of 43 surgical repairs including 26 transabdominal approach(group 1)and 17 transvaginal approach(group 2).There was no significant difference in terms of the patients' age,fistula size,location and the proportion of patients undergoing repairs previously between the two groups.The operative and outcome data of the two groups was compared.Results The surgical time of group 2 was shorter than that of group 1 (median 85 min vs.178 min,Z =-4.436,P ＜ 0.01).The median blood loss was 20 (5-100) ml in group 2 and 50 (20-800) ml in group 1,and there was statistically significant difference (Z =-3.767,P ＜ 0.01).The postoperative hospital stay of group 2 was also shorter than that of group 1 (median 7 d vs.12 d,Z =-3.076,P ＜ 0.01).The follow-up period was 3 to 120 months (median 26 months).The success rate was 82.4％ (14/17) in group 2 and 80.8％ (21/26) in group 1,and there was no significant difference between the two groups (x2 =0.017,P ＞ 0.05).Conclusion Compared with transabdominal repair,transvaginal repair of VVF is a preferred surgical procedure in respect that it is more simple,less invasive and has similar success rate with transabdominal repair.