Wajid Ali, Ijaz Ahmed Kharal, Iftikhar Ijaz, Muhammad Younis.
Outcome of Transvaginal Vesicovaginal Fistula Repair with Martius Fat Pad Flap in Comparison to Simple Closure.
Pak J Med Health Sci Jan ;12(3):1126-8.

Background: VVF is still a very troublesome complication of Obstetric and gynecological procedure in developing countries. Tissue interposition is often required for repair of complex vesicovaginal fistula. Local factors like size, location, and previous radiotherapy as well as surgeon’s experience are detrimental in deciding for vaginal or abdominal approach. Aim: To compare the outcome of martius fat pad flap and primary repair in terms of recurrence for the treatment of vesicovaginal fistula . Methods: This was a randomized control trial , conducted at Department of Urology, Mayo Hospital, Lahore. 120 patients were enrolled in the study and randomly allocated to two groups. Martius Fat Pad Flap was done for group A patients and Group-B patients were treated with simple closure technique. Patients were followed up for period of 7 days to see recurrence by clinical examination and cystoscopy. Data was entered and analyzed on SPSS version 16. Statistical analysis was done according to the proposed plan. Results: In Group-A mean age of patients was 35.50+/-5.98 and in Group-B mean age was 34.05+/-6.16 years respectively. Minimum and maximum age in Group-A was 24 and 47 years whereas 24 and 49 in Group B. Patients follow up showed that in Group-A only 2(3.33%) patients had recurrence while in Group-B 8(13.33%) patients had recurrence at 7th day follow up postoperatively. According to p-value significant association was present between recurrence in relation to treatment group. Conclusion: Results of this comparative trail shows that Martius Fat Pad Flap technique is more effective for treat in vesicovagianl fistula as compared to simple closure technique.

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