Factors Influencing Repair Outcomes of Vesicovaginal Fistula: A Retrospective Review of 139 Procedures

Zhou, Liang; Yang, Tianen; Luo, Deyi; Chen, Shu-Lian; Liao, Banghua; Li, Hong; Wang, Kun‐Jie; Shen, Hong

doi:10.1159/000452166

Cited by 22 publications

(13 citation statements)

References 23 publications

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“…Further, it was reported that large size of Þ stula is more likely to be repaired unsuccessfully. 15,16 However, according to our data analysis, no association was observed between preoperative size of Þ stula and successful surgical repair. Similarly, route of repair (vaginal/ abdominal) has insigniÞ cant effect on the outcome of repair.…”

Section: Discussionmentioning

confidence: 52%

Success Rate of Urogenital Fistula Repair and Predictors of Success-An Audit of Ten Years Data

Tasnim

Bangash

Amin

et al. 2018

Nepal J Obstet Gynaecol

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Aims: To evaluate the association of various predictive factors with the outcome of surgical repair of vesicovaginal fistula. Methods: The retrospective analysis was conducted at Maternal and Child Health, Pakistan Institute of Medical Sciences, Islamabad, and it comprised data related to patients having undergone vesicovaginal fistula repair from January 2008 to June 2018. Statistical analysis of the record was done using SPSS 21 software. Results: A total of 364 patients of urogenital fistula repair were reviewed, with an overall success in 318 (87.4%) cases. There were no significant differences in fistula duration (p0.4), size of fistula (p 0.34) and accessibility (p0.5) between successful and unsuccessful group. However, we found the association between the type of fistula and history of previous repair attempts with the success of fistula repair. Primary surgical repair of vesicovaginal (90.0%), vesicouterine (86%), ureteric (100%) and ureterovaginal (98%) were more successful as compared to repair with the history of 1 previous attempt (90.3%, 83.3%, 66.6% and 75% respectively). Success rate was found to further decrease with the history of more than one repair attempt of vesicovaginal (71.4%) and vesicouterine (66.5%) fistula. Further, successful fistula repair in women was also found to be significantly associated with parity less than 4 (p 0.038). Conclusion: Despite the higher success rate of urogenital fistula repair, it’s important to refer the urogenital fistula patients timely to specialized fistula centres in order to achieve best results.

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Section: Discussionmentioning

confidence: 52%

Success Rate of Urogenital Fistula Repair and Predictors of Success-An Audit of Ten Years Data

Tasnim

Bangash

Amin

et al. 2018

Nepal J Obstet Gynaecol

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“…Rectovesical and vesicovaginal fistulas can complicate the course of illness in patients with cancer. They may result from chemotherapy, radiation damage, malignant tumor invasion, and pelvic surgery complications [ 59 , 60 ]. Although these fistulas are infrequently life-threatening, they substantially reduce the patient's quality of life [ 61 , 62 ].…”

Section: Discussionmentioning

confidence: 99%

“…Although these fistulas are infrequently life-threatening, they substantially reduce the patient's quality of life [ 61 , 62 ]. Vesicovaginal fistulas, abnormal connections between the vagina and bladder, usually present with urinary leakage through the vagina, bleeding, and localized pain [ 59 , 60 ]. Because most are caused by invasive tumors, surgical repair is the preferred treatment approach [ 61 , 63 ].…”

Section: Discussionmentioning

confidence: 99%

Evaluation and Management of Genitourinary Emergencies in Patients with Cancer

Lipe

Mann²,

Babakhanlou

et al. 2021

Emergency Medicine International

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Background. Genitourinary emergencies in cancer patients are common. Most cancer treatments are administered in the outpatient setting, and patients with complications often visit the emergency department. However, there is no recent emergency medicine literature review focusing on genitourinary emergencies in the oncologic population. Objective of the review. To increase awareness of common genitourinary emergencies in patients with cancer and enable the prompt recognition and appropriate management of these conditions. Discussion. Genitourinary emergencies in patients with cancer require a multidisciplinary approach to treatment. The most common genitourinary emergencies in patients with cancer are related to infection, obstructive uropathy, hemorrhagic cystitis, and complications associated with urinary diversions. The treatment approach in patients with infections, including viral infections, is similar to those without cancer. Understanding the changes in the anatomy of patients with urinary diversions or fistulas can help with the management of genitourinary emergencies. Conclusions. Familiarization with the uniqueness of genitourinary emergencies in patients with cancer is important for emergency physicians.

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“…Recently, a randomized study of VVF repair comparing both approaches with or without interpositional flap found equivalent results [7]. So both approaches appear to provide comparable outcome with final discretion depending on the surgeon's experience and training [11].…”

Section: Discussionmentioning

confidence: 99%

Modified Technique of Doubly Folded Peritoneal Flap Interposition in Transabdominal Vesicovaginal Fistula Repair: Our Experience of 36 Cases

et al. 2020

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Correction of vesicovaginal fistula (VVF) using interpositional flaps is an established procedure. In open repair, omental flap gives good results. However, its availability in all the cases is questionable. We utilized our technique of doubly folded peritoneal flap and assessed the outcome of the repair. Methods: Retrospective observational study included 36 cases of open VVF repair, performed during 2010-2019. Preoperative clinical examination, cystoscopy, and imaging were performed routinely. Open transvesical repair as described by O'Conor was performed and doubly folded peritoneal flap was utilized. Intra-and postoperative parameters were recorded. The outcome was assessed after 21 days of catheter removal. A minimum of 6 months of followup was done. Results: Mean age was 44 ± 18 years, and 97.2% of VVF were iatrogenic, mainly after hysterectomy (75.0%) and caesarean section (22.2%). Fistula size ranged from 0.6 to 5.5 cm. Five cases had multiple fistulas and 3 cases were recurrent. Mean flap length and width were 8.0 ± 2.4 and 5.1 ± 1.1 cm, respectively. Mean operative time and estimated blood loss were 94 ± 15 min and 155 ± 45 mL, respectively. Fourteen of 36 patients developed complications of Clavien-Dindo grade I/II. Thirty-five out of 36 cases (97.2%) were cured and remained dry for 6 months after surgery. Three cases reported de-novo urgency and were treated medically. Satisfaction level was good in 91.2% of cases. Conclusion: Transvesical repair using doubly folded peritoneal flap provides an excellent and durable outcome. It is a suitable alternative to the omental interpositional flap.

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Factors Influencing Repair Outcomes of Vesicovaginal Fistula: A Retrospective Review of 139 Procedures

Cited by 22 publications

References 23 publications

Success Rate of Urogenital Fistula Repair and Predictors of Success-An Audit of Ten Years Data

Success Rate of Urogenital Fistula Repair and Predictors of Success-An Audit of Ten Years Data

Evaluation and Management of Genitourinary Emergencies in Patients with Cancer

Modified Technique of Doubly Folded Peritoneal Flap Interposition in Transabdominal Vesicovaginal Fistula Repair: Our Experience of 36 Cases

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