Outcome of surgical repair of vesicovaginal and rectovaginal fistulas

Abstract

Background: Obstetric fistulae (OF), particularly those occurring from obstructed labor, remain a significant issue in poor nations despite reports that their prevalence has declined in industrialized nations. The most prevalent and frequent kind of urogenital fistulas are vesico-vaginal fistulae (VVF). Surgery is usually needed to address this condition.

Objective: The objective of our study was to determine the Outcome of surgical repair of vesicovaginal and rectovaginal fistulas  

Methodology: This retrospective multi-centre study was carried out at the department of gyne and obs Ayub teaching hospital Abbotabad, Lahore General Hospital and Services Hospital Lahore. The study duration was one year from January 2023 to February 2024 by the same surgeon. It included a total of 50 patients who were treated surgically. At three months and six weeks, follow-up appointments were scheduled. Following a successful repair, elective cesarean sections were recommended for subsequent pregnancies. All the data was analyzed by using SPSS version 24.

Results: 88% of VVF cases were caused by obstructed labour, and 18% were iatrogenic. Ninety percent of initial VVF patients were treated surgically using a transvaginal technique, while four percent employed a transabdomenal approach. 54% of patients were single, while 46% needed multiple procedures. In this investigation, the success rate for repairs was 94%.

Conclusion: Obstructed labor was the primary cause of developing fistulas in our research. In our area, birth trauma continues to be a leading cause of VVF/RVF. Public awareness and the provision of adequate healthcare can help prevent disease. With the first surgery, a successful repair is achievable.