Abdul Mannan Qureshi, Khurram Shahzad, Shahzad Anwar, Dhurba B Adhikari, M Nawaz Chughtai.
Transvesical Repair of Difficult Vesicovaginal Fistulas.
Ann King Edward Med Uni Jan ;7(1):1-3.

To assess the efficacy of transvesical repair of difficult vesicovaginal fistulas, results of 18 cases were evaluated in a retrospective study. Our inclusion criteria was fistulas bigger than 2.5cm, previous failed attempts of vaginal repair, high fistulas with vaginal contracture and associated ureterovaginal fistula. Vesicovaginal fistula was approached transvesically by pfannenstiel incision Margins of fistula were excised and tension free suturing of healthy tissues was carried out in layers. Success rate was 88.8%. It is concluded that transvesical repair of difficult vesicovaginal fistulas is a relatively simple procedure with minimal morbidity as compared to conventional transperitoneal approach.

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