A Study on Outcome of VVF Repair at Kumudini Women's Medical College Hospital

Abstract

This cross sectional study was carried out on 101 cases of vesico-vaginal fistula who were admitted and operated in Kumudini Women's Medical College Hospital. The aim of the study was to find out the outcome of vesicovaginal fistula repair. A detailed interview was taken from the patients and attendants by using a questionnaire. Necessary information were collected from the patient's record sheets . Small, medium and large sized fistulae were 59.41%, 26.73% and 11.88% respectively. The result of the study showed that success of fistula repair was 73.27%, though seven cases developed stress incontinence. Totally 27 patients were unsuccessfully repaired. Of which 19 (70.37%) were dropped out, 5(18.52%) were referred and 3(11.11%) had operative failure. Post-operative recovery was mostly (87.13%) uneventful. Urethral leakage (6.93%), blocked catheter ( 2.97%) and UTI (2.97%) were the leading complications. To improve the outcome, more training and skill of surgeons, improvised per-operative and post-operative care is necessary. Approaches should be designed to make the incidence of drop out to zero. DOI: http://dx.doi.org/10.3329/bmj.v40i3.18652 Bangladesh Medical Journal 2011 Vol.40(3):18-20

Surgical Outcome of Hundred Vesico Vaginal Fistula Patients in National Fistula Centre

“…39% experienced incontinence for one to ve years at the time of presentation, with 15% suffering from incontinence for longer than ve years. is ndings are almost similar to a study carried out at Kumudini Women's Medical College Hospital in 2011 by Begum 2 .Based on the complexity of stula, there was no such huge difference between the prevalence of simple (up to >3cm) and complicated (<3cm) stula which was 53% and 47% respectively. ese ndings are quite similar with a study done by Humaira in DMCH in 2003 9 .…”

“…ese ndings are quite similar with a study done by Humaira in DMCH in 2003 9 . Prevalence of complicated stulas were found quite similar to simple stula in DMCH may be due to DMCH is the highest Based on the location, 48%were at Juxtra-cervical region which is more than the previous studies done atKumudiniWomens Medical college Hospital in 2011 2 and DMCH in 2003. 9 Eighty three percent women with VVF had the features of obstructed labour.…”

“…is is also in accordance with other studies carried out in our country. 2 Recovery of most of the patients (75%) were uneventful 9 . e rate of unsuccessful operation is 26 among 100 patients.…”

“…A vesico-vaginal stula (VVF) is an abnormal stulous tract between the bladder and vagina, causing continuous dribbling of urine via the vagina. 2 Vesico-vaginal stula results mainly from obstetrical and gynaecological causes. It is mostly caused by child birth in developing countries like Bangladesh when a woman with prolonged obstructed labour is delivered by unskilled birth attendant, no emergency obstetric care (EOC), lack of proper obstetric management, adolescent pregnancy and repeated child birth.…”

“…3 Radiation treatment for pelvic cancer can lead to stula formation as reported in 1.4% to 5.2% of post-radiation hysterectomies. 2 Focal injuries to the genitourinary tract during hysterectomy and caesarean section causes VVF. Additional causes of vesico-vaginal stula are congenital abnormalities, infection, trauma and foreign bodies but these are relatively rare.…”