Increasing vaginal repair of vesicovaginal fistulae does not affect outcome
BAUS ePoster online library. Itam S.
Jun 27, 2018; 211396
Sarah Itam
Sarah Itam
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Abstract
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Introduction: Traditionally urologists have repaired vesicovaginal fistula (VVF) abdominally and gynaecologists vaginally. We have reviewed the routes of repair in a 2 surgeon series of VVF managed at a tertiary referral centre between 2000 and 2017 to see if this is still the case.

Materials and methods: Review of a prospective database for all patients with VVF for details of all patients with VVF from 2000. Data on patient demographics, fistula aetiology, route of repair and final outcome was recorded for each consecutive 5 year period.

Results: 139 patients of median age 50 years (range 21-88) were referred with VVF during this period. 155 VVF repairs were performed in these women; 62 via the abdominal route and 93 via the vaginal route. Absolute indications for abdominal repair are considered to be requirement for simultaneous ureteric reimplantation and/or clam cystoplasty, or early repair following abdominal procedure. Absolute indications for abdominal repair were present in in 9 women; the remaining 53 women had abdominal repair due to surgeon preference or access difficulty. The details of route of VVF repair, time period and outcomes are shown in Figures 1 and 2.
Anatomical closure was achieved in 97% overall. - with no significant difference between abdominal or vaginal closure routes (P > 0.05).

Conclusion
Vaginal repair of VVF has become increasingly common in urologists hands with excellent fistula outcomes and should be the route of choice if there are no absolute indications for abdominal repair.

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