This prospective descriptive study was carried out to assess the success rate of trans-abdominal repair of vesico-Vaginal fistula.This study was conducted in the department of surgery, gynaecology and urology Ghulam Mohammad Mahar Medical College Hospital Sukkur during a period of last three years, from August 2009 to July 2012.
Total 27 patients of vesicovaginal fistula (V.V.F) were collected from the out patient department (O.P.D) of Surgery, urology and gynecology. After admission of the patients, complete history and clinical examination were done to demonstrate the incontinence subjectively and objectively. All the patients were evaluated; those patients were included who had supra-trigonal multiple or single Vesicovaginal fistulae due to gynecological and obstetrical surgery and were repaired by the abdominal approach. The outcome of the procedure and post-operative complications were recorded.All patients with Supra-trigonal (13 patients), multiple (03), Vesico-Uterine (04 cases) and uretero-vaginal (07 patients) types of V.V.F were operated by abdominal approach successfully.Pelvic surgery (abdominal hystrectomy /LSCS) was the major cause of V.V.F, accounting for 66.66 %(18 Patients), while in remaining 33.33% (09 patients) the obstructed and prolonged labour was the cause . Foley’s catheter was kept up to 03 weeks. All fistulae healed successfully with minor leaking in 02(7.4%) patients which was settled spontaneously. One patient developed post-operative adhesions (small bowel obstruction) and was explored and adhesiolysis was done. 03(11.11%) patients developed post-operative wound infection, managed by dressing.Trans abdominal is an excellent approach for supra-trigonal , vesico-uterine and uretero-vaginal types of V.V.F but careful selection of the patients, experience of surgeon as well as timing of repair are the important milestones for the successful outcome .
Key words: Vesico-Vaginal fistula, abdominal approach, Incontinence
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