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FEATURES OF VESICOVAGINAL FISTULA; AN OBSERVATIONAL STUDY HIGHLIGHTING ITS AWARENESS IN LOCAL POPULATION

Shoukat Mughal, Syed Farhan Ahmed, Imran Memon, Muhammad Rashid Khan

Introduction: The patients of vesicovaginal fistula suffer long term misery due to unacquaintedness of curable nature and proper places of treatment. This study was done to assess the awareness and find out the most familiar causative elements of vesicovaginal fistula, factors responsible for delay in seeking treatment and the results of surgical treatment in our setup Setting: Materials and methods: This was a cross sectional study carried in urology department Liaquat National hospital Karachi from 10 August 2011 to 20 August 2017, with non probability convenient sampling technique performed on 150 patients. Prior permission was obtained from hospital concerned authorities to conduct the study. After informed consent female patients presented with sign and symptoms of vesicovaginal fistula were included in the study while patients presented with vesicouterine fistula, vesicocolic, vesicocutaneous or uretrovaginal fistulas were excluded from the study. All the data was entered and analyzed using SPSS version 20. Frequency and percentages were calculated for qualitative data. . Results: Total 150 patients were enrolled in the study. Majority of patients 66(44%) were of less than 20 years of age. Most of patients i.e. 90(60%) were illiterate and 106(70.66%) patients belonged to poor socioeconomic condition. Commonest cause of vesicovaginal fistula was obstructed labor which was seen in 108(72%) of patients. 28(18.66%) patients presented to hospital for surgery after 4 years of development of fistula while 6(4%) patients presented after 8 years.114(76%) patients have single fistulas while 36(24%) patients have multiple fistulas. 82(54.6%) fistulas were repaired by vaginal approach while 56(37.33%) fistulas were repaired by abdominal route and in 12(8%) patients combined approach was adopted. In 142(94.66%) patients surgery was successful while in 8(5.33%) patients repair was failed. Conclusion: Our study predicted that the commonest cause of vesicovaginal fistula was obstructed labor. Majority of patients were unaware about the curable nature of problem and the place where these types of patients are managed. Success rate of surgery was high in our setup. There is need to prevent the development of fistula by improving the awareness of the problem. Key words: Vesicovaginal fistula, obstructed labor, hysterectomy

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