Surgical repair of vesicovaginal fistulas

Huang, William C.; Zinman, Leonard; Bihrle, William

doi:10.1016/s0094-0143(02)00064-2

Cited by 33 publications

(23 citation statements)

References 31 publications

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“…Da die Bestrahlung eine obliterative Endarteriitis induziert, ist das Areal um den Defekt schlecht vaskularisiert, wodurch die Wahrscheinlichkeit sowohl der Spontanheilung als auch des chirurgischen Verschlusses reduziert ist. Deshalb wird von einigen Autoren eine Wartezeit von mindestens 4-8 Monaten gefordert, bevor eine chirurgische Reparatur in Betracht kommt [24,25]. Während dieser Zeit gilt es, ein rezidivierendes Tumorwachstum zu erkennen.…”

Section: Vesicovaginal Fistulas Diagnostics and Treatmentunclassified

Vesikovaginale Fisteln

et al. 2005

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Vesicovaginal fistulas are often the result of obstetric trauma in third world countries or gynaecologic surgery in developed countries. The incidence of obstetric trauma is approximately 3-4/1000 births in West Africa. The incidence of fistulas as a result of surgery has remained relatively unchanged for years; 75% occur during gynaecologic procedures. The main clinical symptom of a vesicovaginal fistula is urine loss. Different surgical techniques with similar repair results are available: transvaginal approach, transvesical approach and transperitoneal approach. Irrespective of the approach used, requirements for successful repair include adequate surgical exposure, wide mobilization of the bladder and vagina, excision of the fistula tract, tension-free closure of the bladder and vagina, and placement of an interposition flap, i.e. Martius flap, omentum, peritoneum, when indicated. Using these surgical techniques, around 85% of women can be cured from their vesicovaginal fistula with a single operation.

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Section: Vesicovaginal Fistulas Diagnostics and Treatmentunclassified

Vesikovaginale Fisteln

et al. 2005

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“…This method, described in one review as "usually futile" [39], was claimed to have a 50-60% success rate in obstetric fistulas smaller than 2 cm in diameter [37]. Selection criteria for initiation of bladder drainage as an exclusive primary treatment vary widely among authors.…”

Section: Discussionmentioning

confidence: 99%

Spontaneous closure of vesicovaginal fistulas after bladder drainage alone: review of the evidence

Bazi

2006

Int Urogynecol J

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A vesicovaginal fistula may occur as a surgical complication, the result of obstructed labor, or a late manifestation of radiotherapy. Surgical treatment includes many routes and techniques, with a success rate reaching 100%. The spontaneous closure of vesicovaginal fistulae following [corrected] bladder drainage alone for varying periods has been reported by many. The factors favoring the success of this conservative method have not been well examined [corrected] In this investigation [corrected] all articles referring [corrected] to this modality were reviewed [corrected] The parameters studied included etiology, size, interval from [corrected] causative insult to drainage, and duration of drainage. The incidence of spontaneous closure of fistulae [corrected] after bladder drainage alone ranged between [corrected] 0 and 100%. Among all assessed criteria, the interval to drainage seems to have the best correlation with success. This finding [corrected] is most likely explained on the basis of the epithelialization of the fistulous tract with time, preventing spontaneous healing. In the view of the retrospective nature of the reviewed articles, the absence of a detailed classification system, and the heterogeneity of the treatment in question, no solid conclusion regarding management recommendations can be drawn.

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“…In the majority of cases, VVF requires only multilayer tension-free repair through the vagina [2] . There is no controversy concerning the necessity to interpose wellvascularized flaps between the layers of fistula closure in cases of complex VVF or failed primary repair and in cases with anatomical urethral defect.…”

Section: Discussionmentioning

confidence: 99%

“…On the basis of common sense, visual judgment is not always reliable in assessing the quality of the tissues and [1,2] . Autogenous grafts are not without disadvantages, which includes added surgical complexity, donor site morbidity, and limited amounts of material available for grafting procedures [4] .…”

Section: Discussionmentioning

confidence: 99%

“…Most cases are secondary to gynecologic procedures, particularly hysterectomies [1] . Many surgical techniques have been developed to correct VVF, including abdominal, vaginal and laparoscopic approaches [2,3] . Furthermore, various grafts and flaps have been interposed between the bladder and the vagina to promote healing and decrease the incidence of fistula recurrence [4] .…”

Section: Introductionmentioning

confidence: 99%

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Collagen Graft Interposition in Vesicovaginal Fistula Treatment

Robles¹,

Saiz²,

Rioja³

et al. 2009

Urol Int

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Vesicovaginal fistula (VVF) is a quite rare complication of gynecological surgery. The first attempt to repair the fistulous tract offers the best opportunity for cure. We report the successful repair of VVF in 2 patients using a combined anterior vaginal approach and porcine dermal collagen grafting as interposition tissue. Favorable results confirm technical simplicity, safety and efficacy of this procedure.

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Surgical repair of vesicovaginal fistulas

Cited by 33 publications

References 31 publications

Vesikovaginale Fisteln

Vesikovaginale Fisteln

Spontaneous closure of vesicovaginal fistulas after bladder drainage alone: review of the evidence

Collagen Graft Interposition in Vesicovaginal Fistula Treatment

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