Results of early repair of vesicovaginal fistula with preliminary cortisone treatment

Medicolegal aspects of vesicovaginal fistulae

“…Antibiotics are given to prevent infection further jeopardising the health of the tissues and complicating the fistula. Steroid creams have been claimed to improve healing but there is insufficient evidence for routine use [23]. If after this time the fistula appears to have closed a cystogram should be performed before the catheter is removed.…”

Surgical Repair of Vesicovaginal Fistulae: A Ten-year Retrospective Study

“…By tradition, most gynaecologists have repaired vesicovaginal fistulae via the vaginal route (1,7,10,(12)(13)(14), while urologists mostly have tended to favour abdominal repair (2,5,11,15,23). The vaginal repair is a less invasive procedure, with obvious advantages in cosmetics and postoperative discomfort.…”

“…However, no precise definition of late and early repair has ever been reached. In the literature, early repair, that is, from 1 to 3 months, has been advocated by several investigators (1,2,4,10,14,30), while others have preferred late repair, that is, after 3 months (5,7,10,12,15,31).…”

“…early versus late repair. Success rates obtained by both approaches and by either early or late repair are compatible (1,2,5,7,(10)(11)(12)(13)(14)(15). For the majority of cases, it seems that the individual surgeon's experience and comfort should govern his choice of timing as well as his choice of approach, taking the patient's preferences and the actual fistula (location, size, complicating factor, aetiology) into account.…”

The Treatment of Vesicovaginal Fistulae

“…The use of corticosteroids prior to undertaking transvaginal repairs of fistulae was advocated in the early 1960s [20], The results of surgery were excellent, however similar or better results are currently achieved without the use of steroids. If anything at all, the use of steroids may diminish healing capacity, particular of concern in the case of radiation-induced fistulae.…”