Vesico-Vaginal Fistula in Females in 2010–2020: a Systemic Review and Meta-analysis

Shrestha, Dhan Bahadur; Budhathoki, Pravash; Karki, Pearlbiga; Jha, Pinky; Mainali, Gaurab; Dangal, Ganesh; Baral, Gehanath; Shrestha, Marisha; Gyawali, Pratik

doi:10.1007/s43032-021-00832-8

Cited by 19 publications

(21 citation statements)

References 36 publications

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“…VVF involve the posterior surface of the bladder abutting the reproductive tract. A systematic review of 15 studies found that 55.7% of VVF involved the supra-trigonal posterior bladder wall, 27.54% involved the trigone, and the remainder had varied descriptions including "juxta-cervical" [6].…”

Section: Vesicovaginal Fistula 21 Etiologymentioning

confidence: 99%

Urinary Fistulae: Etiology, Diagnosis and Management

Rubin¹,

Danforth²

2024

The Female Pelvis - Anatomy, Function and Disorders

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This chapter covers the most common and clinically relevant types of urinary fistulae. Fistulae are classified by the involved organs and discussed separately. For each type of fistula, its pathogenesis, clinical presentation, recommended workup and management options are reviewed. Advantages and disadvantages of different surgical approaches are explored, however detailed instruction on surgical techniques is not provided. This chapter should prepare the clinician to recognize risk factors and symptoms of urinary fistula, initiate the appropriate diagnostic steps, and guide patients toward informed decisions between the available therapeutic options.

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Section: Vesicovaginal Fistula 21 Etiologymentioning

confidence: 99%

Urinary Fistulae: Etiology, Diagnosis and Management

Rubin¹,

Danforth²

2024

The Female Pelvis - Anatomy, Function and Disorders

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“…Vaginal fistulas defined as a communication between the vagina and the surrounding tissues with the commonest being the bladder and the rectum resulting in vesicovaginal and rectovaginal fistulas, respectively [25]. Obstetrical trauma, obstructed labor, cesarean section, gynecological procedures, and radiotherapy are the commonest causes of genital fistulas [25]. A variety of modalities have been proposed for the management of these fistulas, with a highly variable success rate ranging from 3% to 100% [26].…”

Section: Platelet Rich Plasma and Other Urogynecological Disordersmentioning

confidence: 99%

Platelet rich plasma for the management of urogynecological disorders: the current evidence

Prodromidou

Grigoriadis

Athanasiou

2022

Current Opinion in Obstetrics &Amp; Gynecology

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Purpose of reviewOur objective is to review the currently available literature on the use of platelet-rich plasma (PRP) in patients with pelvic floor disorders and to critically appraise the latest evidence on the safety and efficacy of the PRP application.Recent findingsThe evidence on the use of PRP for the treatment of stress urinary incontinence (SUI) appears promising, although limited to case series, case reports and animal studies. PRP has also been proposed to enhance the surgical outcomes of pelvic organ prolapse (POP) by native tissue repair with promising success rates. The application of PRP in other PFDs including vaginal fistulas, genitourinary syndrome of menopause (GSM), mesh exposure and lichen sclerosus has been also associated with beneficial outcomes and a favorable safety profile.SummaryThe currently available literature indicates that PRP could have a beneficial effect as a single or adjuvant treatment in patients with SUI, POP, GSM, vaginal fistula and genital lichen sclerosus with minimal adverse events. However, valid evidence is still lacking and further well-designed studies are warranted in the field to confirm the validity of the so far reported outcomes.

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“…Urogynecology 2024;30:114-122 DOI: 10.1097/SPV.0000000000001394 V esicovaginal fistula (VVF) represents the most common urogynecologic fistula and may be the result of iatrogenic injury. 1,2 Whereas conservative options such as catheter drainage are sometimes used in the management of VVF, surgical repair is used if these options are unsuccessful. 3 Depending on the clinical scenario, surgical repair may be accomplished via transvaginal, transabdominal, or laparoscopic/robotic approaches.…”

mentioning

confidence: 99%

“…Reported success rates exceeding 90% have been reported in case series for each approach. [2][3][4] Robotic VVF repair first appeared in the literature in 2005 and historically has comprised the least common approach to VVF repair. 4,5 Over the past 2 decades, however, laparoscopic/robotic VVF repair has increased in popularity and has proved to be a safe and effective approach, with success rates similar to transvaginal and transabdominal techniques.…”

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confidence: 99%

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Perioperative Outcomes of Vesicovaginal Fistula Repair by Surgical Approach

Jefferson¹,

Hanson²,

Robinson³

et al. 2023

UROGC

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Importance Data comparing perioperative outcomes between transvaginal, transabdominal, and laparoscopic/robotic vesicovaginal fistula (VVF) repair are limited but are important for surgical planning and patient counseling. Objective This study aimed to assess perioperative morbidity of VVF repair performed via various approaches. Study Design The American College of Surgeons National Surgical Quality Improvement Program database was used to identify women who underwent transvaginal, transabdominal, or laparoscopic/robotic VVF repair from 2009 to 2020. Associations of surgical approach with baseline characteristics, blood transfusion, prolonged hospitalization (>4 days), and 30-day outcomes (any major or minor complication or return to the operating room) were evaluated with χ2, Fisher exact, and Kruskal-Wallis tests. Multivariable logistic regression models assessed the adjusted association of approach with 30-day complications and prolonged hospitalization. Results Overall, 449 women underwent VVF repair, including 252 transvaginal (56.1%), 148 transabdominal (33.0%), and 49 laparoscopic/robotic procedures (10.9%). Abdominal repair was associated with a longer length of hospitalization (median, 3 days vs 1 day transvaginal and laparoscopic/robotic; P < 0.001), higher risk of prolonged length of stay (abdominal, 21.1%; transvaginal, 4.0%; laparoscopic/robotic, 2.0%; P < 0.001), major complications (abdominal, 4.7%; transvaginal, 0.8%; laparoscopic/robotic, 0.0%; P = 0.03), and perioperative transfusion (abdominal, 5.0%; transvaginal, 0.0%; laparoscopic/robotic, 2.1%; P = 0.01). On multivariable analysis, the abdominal approach was independently associated with an increased risk of prolonged hospitalization compared with laparoscopic/robotic (odds ratio, 12.3; 95% confidence interval, 1.63–93.21; P = 0.02) and transvaginal (odds ratio, 6.09; 95% confidence interval, 2.87–12.92; P < 0.001) but not with major/minor complications (P = 0.76). Conclusion Transvaginal and laparoscopic/robotic approaches to VVF repair are associated with lower rates of prolonged hospitalization, major complications, and readmission compared with a transabdominal approach.

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Vesico-Vaginal Fistula in Females in 2010–2020: a Systemic Review and Meta-analysis

Cited by 19 publications

References 36 publications

Urinary Fistulae: Etiology, Diagnosis and Management

Urinary Fistulae: Etiology, Diagnosis and Management

Platelet rich plasma for the management of urogynecological disorders: the current evidence

Perioperative Outcomes of Vesicovaginal Fistula Repair by Surgical Approach

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