- CODEN : IAJPBB
- issn 2349-7750
TITLE:
EFFICACY OF TRANSABDOMINAL VERSUS TRANSVAGINAL APPROACH REPAIR IN THE MANAGEMENT OF VESICOVAGINAL FISTULA
AUTHORS:
Muhammad Ali Suhail, Naveed Ahmed Sheikh, Aijaz Hussain Memon, Mujeebu ur Rehman, Amir Ghani, Sarmad Jamal Siddiqui
ABSTRACT:
Objective: Evaluation of two different surgical techniques of vesicovaginal fistula repair, transabdominal versus transvaginal technique. Setting: Study was conducted at urology department of hospital affiliated to Peoples University of Medical and Health sciences Nawabshah. Design & duration: This is an interventional clinical trial completed in 12 months duration from June 2019 to May 2020. Patients and methods: Patients diagnosed with vesicovaginal fistula after routine examination, and investigations, were selected using consecutive sampling technique for fistula repair. Examination under anesthesia (EUA) and cystocopy were done in all patients. Patients having complicated fistula with involvement of colon,urethra or ureter, or with pre-existing pelvic malignancy were excluded from this study. Patients were put into two groups on the basis of site of fistula and method of repair. One group comprising on patients with low lying uncomplicated fistula, underwent fistula repair using trans-vaginal approach and other group with high type, large or complicated fistula, underwent trans-abdominal approach. Results: Total 40 cases were operated for vesicovaginal fistula. Transvaginal approach was used in 52.5% and transabdominal approach was used in 47.5% cases. Mean age of patients was 31.4±2.4 years. Cause of fistula was obstetrical in 92.5% cases and gynecological in 7.5% cases. Through abdominal repair of fistula omentum was used in 63.2% cases and peritoneum was used in 36.8% cases. Those underwent transvaginal fistula repair showed success rate of 95.2% and those underwent abdominal repair showed success rate of 89.4%. Conclusion: Birth trauma is a major cause of vesicovaginal fistula in our area. Transabdominal and transvaginal both techniques have almost equal success rate with comparable good outcomes but type of tissue used for interposition in suture line play important role in achieving high success rate. Key words: vesicovaginal fistula, birth trauma, trans-abdominal repair, trans-vaginal repair
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NLM ID:101711216 [Serial]
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