Long-Term Functional Outcomes Following Nonradiated Vesicovaginal Repair

Abstract

Long-term followup of patients with vesicovaginal fistula repair indicated no differences in lower urinary tract outcomes at a mean 7-year followup between primary and recurrent repairs. There was a difference in sexual function, although it was not statistically significant. Sexual activity among responders was low.

Vesicovaginal fistulas in the developed world: An analysis of disease characteristics, treatments, and complications of surgical repair using the ACS‐NSQIP database

“…The majority of patients in our study underwent a repair by means of vaginal surgical approach. These findings are similar to those seen in other North American series . We also found no patient demographic characteristics that differed between patients chosen for an abdominal versus vaginal approach.…”

“…No long‐term differences were seen between the two approaches in lower urinary tract symptoms and sexual function validated questionnaires. The focus of this study was on long‐term functional outcomes and did not make mention of immediate postoperative complications . Additionally, this series represents a single institution experience and thus lacks the generalizability of a national cohort.…”

Abdominal Approach for Vesicovaginal Fistulas: Outcomes and Risk Factors for Failure

“…In contrast, a retrospective evaluation of 41 VVF/UVF at a tertiary center in the United Kingdom found that complex abdominal fistula repairs had a higher risk failure if omental flap interposition was not used [7]. Additionally, in a contemporary series of abdominal and vaginal VVF repair, Lee, et al reported that an interposition flap was used in all 19 of their abdominal VVF repair to good outcomes [5]. A randomized trial is needed to better assess which VVF characteristics and surgical approaches benefit most from concomitant interposition use.…”

“…Many published abdominal VVF series focus entirely on obstetric fistulas [4] or combine outcomes for vaginal and abdominal procedures [5,6]. Given the small sample sizes and potential heterogeneity among these existing series, limited data are available to counsel contemporary, nonobstetric VVF patients undergoing abdominal repairs about outcomes and risk factors for surgical failure.…”

A clinical audit of female urinary incontinence at a urogynaecology clinic of a tertiary hospital in Durban, South Afric

“…Lee et al, [14] in a retrospective chart review from 1996 to 2011, reported on 66 patients with VVFs, 42 undergoing primary treatment (n=31 vaginal approach v. n=11 abdominal); the overall repair success rate was 97%. It is difficult to compare the success rates between the two studies, as Lee et al had no patients with complex UGFs as seen in our study.…”