COMPARISON OF SUCCESSFUL OUTCOME OF FLAP VERSUS NO-FLAP IN O’CONOR & SOKOL TECHNIQUE FOR VESICOVAGINAL FISTULA REPAIR

Abstract

To compare the successful outcome of flap versus no-flap in O'Conor & Sokol technique for simple vesicovaginal fistula (VVF) repair. Methods: This quasi-experimental study was conducted in department of Urology, Institute of Kidney Diseases, Hayatabad Medical Complex Peshawar, Pakistan from March 2015 to December 2019. During this study period, 64 eligible patients, selected through non-probability convenient sampling technique were assigned to two Groups. Group A included 34 patients who underwent VVF repair through O'Conor & Sokol technique without interposition flap while Group B comprised 30 patients with VVF repair with interposition flap. Patient getting completely dry with no urinary incontinence at primary endpoint of 6 months was labelled as successful outcome. All the pre-operative, per-operative and postoperative data was collected on structured proforma and analyzed on SPSS version-21. Results: The mean age of the patient was 33.8±7.8 years in group A and 35±6.3 years in group B. About 76.5% (n=26/34) patients in group A and 80% (n=24/30) patients in Group B developed VVF due to obstetrical trauma. Overall, O'Conor and Sokol technique of VVF repair was successful by curing urinary incontinence in 95.3% (n=61/64) patients. Successful outcome for O'Conor & Sokol technique was achieved in 94.1% (n=32/94) patients in Group A and 96% (n=29/30) patients in Group B, at 6 months of follow-up (p>0.05). Conclusion: There is no significant difference between interposition flap and noflap in outcome of simple VVF repair through O'Conor & Sokol technique. The decision of interposition can be individualized depending upon preference of surgeon.