Muhammad Akram Malik, Zahid Iqbal.
Vesicovaginal fistulae: etiology and management at Allied Hospital, Faisalabad
Pak J Surg Oct - Dec 2005;21(2):93-6.
Department of Urology, Allied Hospital & Punjab Medical College, Faisalabad
Objective: To determine the etiological factors responsible for Vesico-Vaginal Fistulae (VVF) and review our experience of their management. Design & Duration: Retrospective descriptional study conducted over a period of six years. Setting: Department of Urology, Allied Hospital & Punjab Medical College, Faisalabad. Patients: All patients who presented with Vesicovaginal Fistula. Methodology: The record of 120 patients who presented with VVF over the past six years were reviewed and analyzed. Intra-venous urography (IVU), cystourethroscopy and vaginoscopy were performed to evaluate each patient. VVF were repaired by vaginal and abdominal approaches, using flaps where required. The outcome of the procedures and their post-operative complications were observed and recorded. Results: Out of the 120 patients who presented with VVF, prolonged / obstructed labour was found to be the cause in 82 (68.33%) patients, and pelvic surgery in 36 (30%) patients. VVF was repaired by the vaginal approach in 42 (39.25%) patients with a success rate of 85.71%, whereas the abdominal approach was used in 67 (62.61%) patients with a success rate of 94%. Conclusion: Obstructed / prolonged labour is the major cause of VVF in the third world countries like Pakistan. Low literacy rate, poverty and deficient obstetrical facilities are mainly responsible for them. However, with improved surgical techniques and skills, they are now better managed in our country. Steps should be taken by the government and NGOs to provide proper obstetrical facilities to the women of rural areas.
Category: Urology
Keywords: Vesicovaginal Fistula. Vagina. Urinary Bladder. Ureterovaginal Fistula. Fistula.
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