Factors Associated with Vesicovaginal Fistula and Their and Treatment Outcome

Abstract

Vesicovaginal fistulas (VVF) also known as vesicovaginal fistula, have become a growing public health concern especially of developing countries. The most cited reason in literature of VVF is by prolonged and obstructed labor. With improvement in quality care delivery in health around the globe, the etiology of VVF too evolving in the country. Objective: This study was done to find out the factors associated with vesicovaginal fistula and to determine the success rate of operative procedure for treatment of vesicovaginal fistula. Method: This cross sectional study was carried out in Department of Gyneacology and Obstetrics in Liaquat University Hospital, Hyderabad from January 2021 to December 2021 among 60 women at different ages suffering from vesicovaginal fistula due to gynaecological or obstetrical causes or malignancy. Result: Majority of the patients were “young primipara with short stature and malnourished, coming from lower socioeconomic condition of rural areas. Prolonged labor 24 (40%) was the most common cause of vesicovaginal fistula, followed by gynaecological surgeries mainly hysterectomies 18 (30%) and malignancy 4 (6.6%) rare cause. The success rate of repair following first and second attempt was 92% and 8% respectively. Overall success rate was 48 (96%) and functionally failed with a failure in 2(4%) cases. This study showed main cause for developing fistula showing prolonged labor and majority of patient were treated pervaginally. Most of the cases (96%) had successful repair which is very encouraging and correlates well with recently published series. Conclusion: Fistula can be totally preventable by proper antenatal care identification of high risk cases, timely referral, proper intranatal, postnatal care, and proper training. So improvement of health care services and dedication will prevent this type of morbidity. The best results are obtained when repair of vesicovaginal fistulae is carried out under optimal conditions”.