Asif Abbas Khawaja, Riaz Ahmed, Rafique Anjum.
Role of peritoneum as interposition tissue in the management of vesicovaginal fistula
J Surg Pak Mar 2005;10(1):2-4.
Nishtar Hospital, Multan

Objective: To study the relative efficacy and results of the use of peritoneum as interposition tissue between vesical and vaginal repair in the management of VVF and compare the results with omentum pedicle flap. Design: It is a comparative study. Place & Duration: The study included twenty patient of VVF, who were operated in the Dept of Urology Nishtar Hospital Multan, from 301 June 2003 to 30, July 2004. Subject And Methods: In 10 patients (Group I), omentum was used as interposition tissue between the vesical and vaginal suture lines and in 10 patients; (Group II) peritoneum was used as interposition tissue between the two repairs. Results: The study included 20 patients of VVF with mean age of 27 years. The leading cause of hysterectomy was the dysfunctional uterine bleeding in 8 patients (40%). Fifteen patients (75%) came from rural areas and 5 patients (25%) were referred from gynecological units of Nishtar Hospital Multan. In group I patients, with omentum as interposition tissue, two patients (20%) developed high-grade fever three patients (30%) developed persistent vomiting, two patients (20%) needed blood transfusion, four patients (40%0) developed UTI. One patient (10%) developed leakage of urine per vagina on 18t postoperative day and one patient (10%) developed intestinal obstruction. In group II patients, one patient (10%) developed high-grade fever one patient (10%) developed persistent vomiting, three patients (30%) needed blood transfusion, three patients (30%) developed UTI. None of the patients developed any leakage of urine or intestinal obstruction. Conclusion: The study showed that peritoneum is equally good as omentum for use as interposition tissue in transabdominal repair of VVE It is also easy to mobilize with a comparable complication rate.

Category: Urology
Keywords: Vesicovaginal Fistula. Omentun. Peritoneum. Fistula.

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