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Archives of Gynecology and Obstetrics

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01-07-2015 | General Gynecology

Combined vagino-abdominal approach for management of vesicovaginal fistulas: a 10 years’ experience

Authors: Ali Razi, Mohammad Mohsen Mazloomfard, Hossein Ajami, Aida Moeini

Published in: Archives of Gynecology and Obstetrics | Issue 1/2015

Abstract

Background

Vesicovaginal fistulas (VVF) are an uncommon but serious complication of gynecological surgery. The aim of this study was to report our experience with the repair of VVF using combined vaginal and extraperitoneal abdominal approaches.

Materials and methods

Between 2000 and 2012, 15 consecutive females with VVF were managed with combined vaginal and extraperitoneal abdominal procedures. After assessment by voiding cystourethrography and urethrocystoscopy, the operation was performed at the standard lithotomy position.

Result

Fifteen patients were included in this study with mean age 51.8 ± 11.9 years. The mean fistula size was 2.1 ± 0.7 cm and all of them were located in supra-trigonal region except one case that fistula defect extend to the bladder trigon. Fourteen patients reported complete resolution of urinary incontinence during mean follow-up of 3.5 years. Fistula was recurred in one female 1 year after repair due to cancer recurrence and radiotherapy treatment. No intraoperative complication including massive bleeding or ureteral damage was observed.

Conclusion

Our experience with combined vaginal and extraperitoneal abdominal repair of a vesicovaginal fistula shows its feasibility and safety with good results.

Singh V, Sinha RJ, Mehrotra S, Sankhwar SN, Bhatt S (2012) Repair of vesicovaginal fistula by the transabdominal route: outcome at a north Indian tertiary hospital. Int Urogynecol J 23(4):411–416CrossRefPubMed

Hilton P (2003) Vesico-vaginal fistulas in developing countries. Int J Gynecol Obstet. 82(3):285–295CrossRef

Cohen BL, Gousse AE (2007) Current techniques for vesicovaginal fistula repair: surgical pearls to optimize cure rate. Curr Urol Rep. 8(5):413–418CrossRefPubMed

Rizvi SJ, Gupta R, Patel S, Trivedi A, Trivedi P, Modi P (2010) Modified laparoscopic abdominal vesico-vaginal fistula repair–”Mini-O’Conor” vesicotomy. J Laparoendosc Adv Surg Tech A. 20(1):13–15CrossRefPubMed

Eilber KS, Kavaler E, Rodríguez LV, Rosenblum N, Raz S (2003) Ten-year experience with transvaginal vesicovaginal fistula repair using tissue interposition. J Urol 169(3):1033–1036CrossRefPubMed

Petrou SP, Jones J, Parra RO (2002) Martius flap harvest site: patient self-perception. J Urol. 167(5):2098–2099CrossRefPubMed

Miklos JR, Moore RD (2012) Vesicovaginal fistula failing multiple surgical attempts salvaged laparoscopically without an interposition omental flap. J Minim Invasive Gynecol. 19(6):794–797CrossRefPubMed

O’Conor VJ (1980) Review of experience with vesicovaginal fistula repair. J Urol 123:367–369PubMed

Lee RA, Symmonds RE, William TJ (1988) Current status of genitourinary fistula. Obstet Gynecol 72:313PubMed

10.

Nerli RB, Reddy M (2010) Transvesicoscopic repair of vesicovaginal fistula. Diagn Ther Endosc. 2010:760348CrossRefPubMedCentralPubMed

11.

Rajamaheswari N, Chhikara AB, Seethalakshmi K, Bail A, Agarwal S (2012) Trans-vaginal repair of gynecological supratrigonal vesicovaginal fistulae: a worthy option. Urol Ann. 4(3):154–157CrossRefPubMedCentralPubMed

12.

Bing-Shu L, Li H, Qin W, Min H, Yan-Xiang C (2011) Clinical effects of transvaginal vesicovaginal fistula repair surgery mediated by the Foley catheter (64 cases). Clin Exp Obstet Gynecol 38(4):360–363PubMed

13.

Langkilde NC, Pless TK, Lundbeck F, Nerstrøm B (1999) Surgical repair of vesicovaginal fistulae–a ten-year retrospective study. Scand J Urol Nephrol 33(2):100–103CrossRefPubMed

14.

Garthwaite M, Harris N (2010) Vesicovaginal fistulae. Indian J Urol. 26(2):253–256CrossRefPubMedCentralPubMed

15.

Flynn MK, Peterson AC, Amundsen CL, Webster GD (2004) Functional outcomes of primary and secondary repairs of vesicovaginal fistulae via vaginal cuff scar excision. Int Urogynecol J Pelvic Floor Dysfunct. 15(6):394–398CrossRefPubMed

16.

Phipps S, Lim YN, McClinton S, Barry C, Rane A, N’Dow J (2006) Short term urinary catheter policies following urogenital surgery in adults. Cochrane Database Syst Rev. 19(2):CD004374

17.

Hunter KF, Bharmal A, Moore KN (2013) Long-term bladder drainage: suprapubic catheter versus other methods: a scoping review. Neurourol Urodyn 32(7):944–951CrossRefPubMed

18.

Katsumi HK, Kalisvaart JF, Ronningen LD, Hovey RM (2010) Urethral versus suprapubic catheter: choosing the best bladder management for male spinal cord injury patients with indwelling catheters. Spinal Cord. 48(4):325–329CrossRefPubMed

19.

Das Mahapatra P, Bhattacharyya P (2007) Laparoscopic intraperitoneal repair of high-up urinary bladder fistula: a review of 12 cases. Int Urogynecol J Pelvic Floor Dysfunct 18:635–639CrossRefPubMed

20.

Lee JH, Choi JS, Lee KW, Han JS, Choi PC, Hoh JK (2010) Immediate laparoscopic nontransvesical repair without omental interposition for vesicovaginal fistula developing after total abdominal hysterectomy. JSLS 14:187–191CrossRefPubMedCentralPubMed

Title: Combined vagino-abdominal approach for management of vesicovaginal fistulas: a 10 years’ experience
Authors: Ali Razi
Mohammad Mohsen Mazloomfard
Hossein Ajami
Aida Moeini
Publication date: 01-07-2015
Publisher: Springer Berlin Heidelberg
Published in: Archives of Gynecology and Obstetrics / Issue 1/2015
Print ISSN: 0932-0067
Electronic ISSN: 1432-0711
DOI: https://doi.org/10.1007/s00404-014-3589-6

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Combined vagino-abdominal approach for management of vesicovaginal fistulas: a 10 years’ experience

Abstract

Background

Materials and methods

Result

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Materials and methods

Result

Conclusion

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