Mumtaz Rasool, Shafqat Ali Tabassum, Fariha Mumtaz.
Vesico-vaginal fistula repair; urologist`s experience at Bahawalpur.
Professional Med J Jan ;13(3):445-52.

Objectives: To evaluate outcome of surgical repair of VVF with transabdominal and transvaginal approaches. Design of study: Prospective study. Setting: Depart of Urology Bahawal Victoria Hospital Bahawalpur. Period: Jan 1999 to Dec 2004. Materials & Methods: All consecutive patients with VVF irrespective of age and aetiology were included in this study. Patients with very large VVF and involvement of bladder neck were excluded. These patients were analysed for results of surgical repair by trans-abdominal and transvaginal approaches. Results This study included 26 patients with age range between 20-48 years (mean age of 34 years). Etiology of VVF was observed to be transabdominal hysterectomy in 15 patients, transvaginal hysterectomy in one patient. While obstructed prolonged labour caused VVF in 10 patients. Transabdominal repair was done in 18 patients while 08 patients have undergone transvaginal repair after investigations and evaluation. We achieved 94.45% success with transabdominal repair of VVF while 100% success with transvaginal repair. Conclusions: The etiology of this disease is preventable. It is best to wait for at least 03 months after occurrence of VVF, so that inflammatory changes due to previous surgery /birth trauma may have settled completely before attempting at repair. Best resultrs are achieved at first attempt of repair. Both approaches of surgical repair of VVF have good results.

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