VESICOVAGINAL FISTULA: AN EXPERIENCE OF 30 CASES AT AYUB TEACHING HOSPITAL ABBOTTABAD

Authors

  • Raza M. Khan
  • Nabeela Raza
  • Mohammed Jehanzaib
  • Ruqia Sultana

Abstract

Background: Vesicovaginal fistula (VVF) is a disease that is rare in developed world but isfrequently seen in poorer countries. It is mostly a result of gynaecological or obstetricalprocedures. This study reports our experience of VVF. Methods: This study was carried out atdepartment of Urology, Ayub Teaching Hospital, Abbottabad from June 1998 to June 2004.Detailed history was taken to record age, nature of trauma, time interval of appearance of fistulaand previous attempts of repair if any. In addition the results of repair were evaluated. Results:During this six years study period a total of 30 cases of urinary incontinence due to VVF werereferred from Gynaecology and Obstetrics department for management, many gave history of birthtrauma resulting in leakage of urine per vaginum. Majority of patients with VVF were between 21-40 years of age. All the patients presented with total incontinence of urine. Most commonetiological factor was obstructed labour (63.33%). The other factors were caesarian section(13.33%), hysterectomy (13.33%), forceps delivery (3.33%) and bladder calculus (3.33%). Asingle case was due to carcinoma cervix and post irradiation (3.33%). Three out of 30 patients hadone or more previous fistula repair attempts, while in the rest repair was not attempted before. Wecarried out transvesical repair in all patients, 80% of patients were completely cured and symptomfree, 10% had stress incontinence with frequency of micturition but no vaginal leakage. Failurewas 10%. Conclusion: VVF is frequently encountered in Hazara division of Pakistan. It is mostlydue to obstetrical causes.Keywords: Vesicovaginal Fistula, urology, incontinence

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Vol. 17 No. 3 (2005): JOURNAL OF AYUB MEDICAL COLLEGE, ABBOTTABAD

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