Changing trends in the etiology and management of vesicovaginal fistula

Malik, Muhammad Anwar; Sohail, M. Rizwan; Malik, Muhammad TB; Khalid, Nauman; Akram, Adeen

doi:10.1111/iju.13419

Cited by 63 publications

(65 citation statements)

References 32 publications

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“…It occurs especially in women living in the remote rural areas of Pakistan. In our study, we found that 75% patients were residents of rural areas as reported by other 3,5,11 studies. This sad reflection of low socio economical aspect is seen all over the developing world, as 60-70 percent of patients were residents of rural areas in different studies.…”

Section: Methodssupporting

confidence: 87%

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

Ali

Hayat

Khan

et al. 2020

KMUJ

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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.

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Section: Methodssupporting

confidence: 87%

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

Ali

Hayat

Khan

et al. 2020

KMUJ

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“…In addition, postvoid residuals were lower than 50 mL in all patients. one side and vaginal flora on the other [17][18][19]. As we already mentioned, in Western countries, the majority of VVFs are commonly associated with iatrogenic injury that comes about during gynecological surgery, mainly hysterectomy [20,21].…”

Section: Resultsmentioning

confidence: 96%

Platelet-Rich Plasma as Adjuvant Therapy for Recurrent Vesicovaginal Fistula: A Prospective Case Series

Streit-Ciećkiewicz

Futyma

Miotła

et al. 2019

JCM

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Vesicovaginal fistula (VVF) is the nonphysiological communication between the bladder and vagina, and surgical closure is the gold treatment standard. Despite that successful closure occurs in around 85% of patients after the first repair, recurrence remains a highly distressing complication for patients and surgeons. The aim of our study was to evaluate the efficacy of a platelet-rich plasma (PRP) injection as a supportive treatment in the surgical repair of recurrent VVF. Between January 2018 and July 2019, 16 patients with recurrent VVF were injected with PRP in a tertiary gynecological department. Subsequently, a surgical Latzko procedure for VVF closure was scheduled 6-8 weeks after the PRP injection allowing proper neovascularization and remodeling of surrounding tissues. Patients were considered cured if no leakage was observed after surgery and negative dye test results were indicated at follow-up. All patients who were examined therein remained dry. To the best of our knowledge, this is the first study aiming to assess PRP injections as a supporting treatment prior to surgical procedure for recurrent VVF. Preliminary results are encouraging, and we incorporated this method in our clinical practice. Further reports on a larger group will follow.

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“…Traditional teaching typically dictates waiting at least three months after childbirth before surgically repairing a fistula to allow time for healing and inflammation to subside as well as recovery from central necrosis, edema, or infection. 4,7,11 Additionally, conservative management for women who present within the first three months for repair may help the fistula spontaneously close. 4 However, some experts would argue, that it is reasonable to repair before the 3-month mark so long as the fistula tract is mature and the tissue appears healthy.…”

Section: Discussionmentioning

confidence: 99%

Risk factors for perioperative blood transfusions after urogenital fistula repair in Uganda: a retrospective cohort study

Potluri

Holt

Tanner

et al. 2021

Preprint

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Objective: To determine the incidence of and risk factors for perioperative blood transfusions after urogenital fistula repairs in Uganda. Design: A retrospective cohort study. Setting: A community hospital in Masaka, Uganda. Population: Women who underwent fistula repair at the Kitovu Hospital between 2013 and 2019. Methods: Retrospective review of demographics, and clinical perioperative characteristics of patients surgically treated for urogenital fistula. Patient characteristics were compared between those who did and did not require a blood transfusion. Main Outcome Measures: need for perioperative blood transfusion, risk factors Results: 546 patients treated for urogenital fistulas were included in this study. The median age was 31.1 ± 13.2. A vaginal surgical approach was used in the majority of patients (84.6%). Complications occurred in 3.5% of surgical repairs, and the incidence of blood transfusions was 6.2%. In multivariable analyses, women with fistula repairs approached abdominally were 4.3 (95% CI: 1.85–10.00) times more likely to require transfusions than vaginal operations. A borderline association was observed between timing of repair and perioperative transfusions such that patients who underwent repair after three months from the time of developing the fistula were at lower risk of perioperative transfusions (aOR: 0.48, 95% CI: 0.22–1.04). Conclusions: The incidence of blood transfusions among urogenital fistula repairs in our population is twice that of developed nations. An abdominal surgical approach to urogenital fistula is a significant risk factor for perioperative blood transfusions. Timing of repair may warrant further study.

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Changing trends in the etiology and management of vesicovaginal fistula

Cited by 63 publications

References 32 publications

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

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

Platelet-Rich Plasma as Adjuvant Therapy for Recurrent Vesicovaginal Fistula: A Prospective Case Series

Risk factors for perioperative blood transfusions after urogenital fistula repair in Uganda: a retrospective cohort study

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