Imran Memon, Syed Farhan Ahmed, Shaikh Sajid Ali, Aziz Abdullah.
An audit of vesico vaginal fistula at liaquat national hospital.
Isra Med J Jan ;7(4):191-4.

OBJECTIVE: To determine the common cause of iatrogenic genito-urinary fistula and its management in the term of success and failure rate. STUDY DESIGN: An interventional study. PLACE AND DURATION: Urology Department of Liaquat National Hospital Karachi from 1 January 2009 to 25 July 2013. METHODOLOGY: Total 193 patients with complaints of urinary incontinence due to iatrogenic fistula were included in the study. The data of patients was recorded on predesigned proforma which including demographic characteristics, causes of fistula and management. Physical examination and investigations were carried out. Cases were operated by urologist. Success rate was observed till the 6 weeks after management. RESULTS: Out of 193 cases, most common type of iatrogenic fistula was vesicovaginal fistula seen in 90.15% cases, while 5.69% cases had uretrovaginal fistula. Mean age of the patients was 29.0 ±1.06 SD. In the majority 72% vesicovaginal fistula developed due to abdominal hysterectomy, while in the 12.95% cases developed fistula after cesarean hysterectomy. Repair of fistula was attempted through transvaginal route in 72.12% patients, through transabdominal route in 20.74% patients while combine abdomino vaginal route was adopted in 4.14% patients. Tissue interposition was done in 12 cases. All the patients having graft were repaired successfully and had no leakage of urine. Among 95.34% were treated successfully after first attempt while 4.65% patients had developed th th recurrence of fistula on 8 to 14 day. CONCLUSION: It is concluded that mostly iatrogenic fistula developed due to gynecological hysterectomy.

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