To describe that the transvaginal approach is an excellent route for the repair of vesico vaginal fistula without compromising on success rate. Material and Method: It is a reterospective analysis of 64 cases operated in 10 years. All were operated through transvaginal approach. Study included all supratrigonal, trigonal and infratrigonal fistulas as classified on cystoscopic findings bases. Results: Sixty four patients with vesico vaginal fistula were included in the study. The age of patients was from 20 to 58 years with a mean age of 44.6 years. According to age these were divided into four groups. The cause of vesico vaginal fistula was abdominal hystrectomy in 57 (89.06%) patients while obstructive labour in 7 (10.96%) patients. The size of fistula was further categorized in three groups. The success rate was 87.5% (56 patients) in first attempt while the fistula of remaining 8 patients (12.5%) was successfully repaired in second attempt. Supra trigonal fistula was present in 54 (84.38%) patients while 10 (15.62%) patients had trigonal or infra trigonal fistula. Conclusion: By comparing different approaches, the vaginal approach had a comparable success rate with less morbidity. We suggest, for repair of vesico vaginal fistula, the transvaginal approach should be a preferred approach for a vaginally accessible fistula over tranabdominal approach.

Urinary retention after postpartum can be defined as “inability of the patient to pass urine after six hours of postpartum. Objective: To determine the role of catheterization in patients with postpartum urinary retention. Methods: It was multicenter study. Patients from five different hospitals were included in the study. Duration of study was one and half years. Patients suffering from overt postpartum urinary retention who refused self intermittent catheterization were included in the study. Results: Total 68 patients were included in the study from five different teaching hospitals. In Social Security Teaching Hospital 13 patients, in Lady Wallingdon Hospital 32patients, in Lahore General Hospital 13, in Ali Fatima Teaching Hospital 12 and in Central Park Hospital 8 patients were reported. The age of these patients was from 18 to 29 years with a mean age of 21 years (+ 1.6). The duration of catheterization was from 3 to 18 days with mean days was 7 (+ 1.8). Conclusions: In overt type of postpartum urinary retention, early treatment results in saving patients to develop long term urinary complications.