Transvaginal repair of vesicovaginal fistulae

Frohmüller, H.; Hofmockel, G.

doi:10.1007/s001200050151

Cited by 12 publications

(6 citation statements)

References 19 publications

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“…The vaginal approach is a less invasive approach with minimum morbidity, decreased requirement of analgesics, allows high cure rate, short recovery, relatively lower costs and does not require sophisticated or expensive material as needed for laparoscopic or robot assisted repairs[314–16] and hence should be adopted whenever feasible in supratrigonal VVF. However, details regarding these factors were not included in the current study which is a limitation of this review.…”

Section: Resultsmentioning

confidence: 99%

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Trans-vaginal repair of gynecological supratrigonal vesicovaginal fistulae: A worthy option!

Rajamaheswari¹,

Chhikara²,

Seethalakshmi³

et al. 2012

Urol Ann

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Objective:To determine the appropriateness of vaginal approach for gynecological supratrigonal vesicovaginal fistulae.Patients and Methods:Retrospective review of consecutive women with gynecological supratrigonal Vesico Vaginal Fistulae (VVF) repaired at the fistula unit of Urogynecology department between 1996 and 2011 was done.Out of 48 cases of supratrigonal VVF of gynecological origin identified; 34 (70.8%) cases were repaired vaginally and 14 (36.8%) abdominally with a mean follow-up period of 52.8 (2-132) months.Results:Overall 95.8% were successfully cured at first attempt. The success rate of vaginal repair (94.8%) at first attempt was comparable to that of abdominal repair (100%) (P value = 0.8946). Amongst two failed vaginal repairs, one was successfully cured by subsequent vaginal repair and other by abdominal repair.Conclusion:Three fourth gynecological supratrigonal VVF can be repaired vaginally in first attempt with success rate comparable to abdominal approach. On the basis of this study we postulate that vaginal approach should be preferred over abdominal approach for repair of all vaginally accessible supratrigonal VVF of gynecological origin.

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Section: Resultsmentioning

confidence: 99%

“…Both vaginal approach[34] as well as abdominal approach[5–7] are described for VVF repair. Each approach has its merits and demerits.…”

Section: Introductionmentioning

confidence: 99%

Trans-vaginal repair of gynecological supratrigonal vesicovaginal fistulae: A worthy option!

Rajamaheswari¹,

Chhikara²,

Seethalakshmi³

et al. 2012

Urol Ann

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“…We attempt to manage the majority of VVFs with a transvaginal procedure shown to be highly successful in multiple series [4,[25][26][27][28]. The greatest advantage for transvaginal repair is the avoidance of an abdominal procedure with improved pain control and recovery time.…”

Section: Transvaginal Repair Of Vvfsmentioning

confidence: 99%

“…[4,[25][26][27][28] Simple closure of a small VVF can be performed as an outpatient surgery and should result in a three-layer closure. We typically place an 8-French Foley catheter through the fistula tract from the vaginal side for traction and assistance with dissection (Fig.…”

Section: Transvaginal Repair Of Vvfsmentioning

confidence: 99%

Current techniques for vesicovaginal fistula repair: Surgical pearls to optimize cure rate

Cohen¹,

Gousse

2007

Curr Urol Rep

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Vesicovaginal fistulas (VVFs) are a devastating consequence of prolonged labor in developing countries and pelvic surgery in developed countries. Clinical history, physical examination, and pertinent radiographic studies are necessary for proper diagnosis. Endoscopic management can lead to successful closure of small fistulas; the advent of tissue bioglues has made this modality more promising. However, the majority of patients will require transvaginal or transabdominal repair of the fistula. This article reviews the basic principles of fistula closure and discusses adjuvant techniques with tissue interposition grafts; techniques for successful closure of fistulas; and newer modalities for repair using tissue bioglues, laparoscopy, and robotic surgery.

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“…Transvaginal repair is preferred as it is associated with lower analgesic use, shorter hospital length of stay, and lower costs. 20 For more complicated cases at the bladder neck, combined trans-vaginal trans-abdominal approach may be required.…”

Section: Cuaj -Original Researchmentioning

confidence: 99%

Urethrovaginal fistula repair with or without concurrent fascial sling placement: A retrospective review

Neu¹,

Locke

Goldenberg

et al. 2020

CUAJ

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Introduction: We sought to review outcomes of urethrovaginal fistula (UVF) repair, with or without concurrent fascial sling placement. Methods: All patients diagnosed with UVF at our center from 1988–2017 were included in this study. Patient charts were reviewed from a prospectively kept fistula database, and patient characteristics and surgical outcomes were described. Descriptive statistics were applied to compare complication rates between patients with or without fascial sling placement at the time of UVF repair. Results: A total of 41 cases of UVF were identified, all of which underwent surgical repair. Median age at diagnosis was 49 years (interquartile range [IQR] 35–62). All patients had undergone pelvic surgery. UVF etiology was secondary to stress urinary incontinence (SUI) surgery in 17 patients (41%) and urethral diverticulum repair in seven patients (17%). The most common presenting symptom was continuous incontinence in 19 patients (46%). Nineteen patients had a fascial sling placed at the time of surgery (46%), with no significant difference in complication rates (26% vs. 23%, p=0.79). Two patients had Clavien-Dindo grade I complications (5%) and one had a grade III complication (2%). Four patients had long-term complications (10%), including urinary retention, chronic pain, and urethral stricture. Two patients had UVF recurrence (5%). Median followup after surgery was 21 months (IQR 4–72). Conclusions: UVF should be suspected in patients with continuous incontinence following a surgical procedure. Most UVF surgical repairs are successful and can be done with concurrent placement of a fascial sling.

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Transvaginal repair of vesicovaginal fistulae

Cited by 12 publications

References 19 publications

Trans-vaginal repair of gynecological supratrigonal vesicovaginal fistulae: A worthy option!

Trans-vaginal repair of gynecological supratrigonal vesicovaginal fistulae: A worthy option!

Current techniques for vesicovaginal fistula repair: Surgical pearls to optimize cure rate

Urethrovaginal fistula repair with or without concurrent fascial sling placement: A retrospective review

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