Vesicovaginal Fistula After Laser Vaporization of Vaginal Condyloma

Colombel, Marc; Pedron, Philippe; Missirlu, Antoine; Abbou, Claude C.; Chopin, Dominique

doi:10.1016/s0022-5347(01)66802-2

Cited by 7 publications

(1 citation statement)

References 3 publications

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“…Globally, the cause of VVF is abdominal hysterectomy in 83%, vaginal hysterectomy in 8%, radiation in 4%, and other in 5% of the cases [16]. Further causes include urological and gynecological instrumentation [17], retroperitoneal, vascular and pelvic surgery, inflammatory and infective diseases [18], and foreign bodies, for example, a forgotten pessary ring [19], congenital VVF [20], sexual trauma [21], and vaginal laser treatments [22]. Approximately 3-5% of VVF occur as a result of a malignant tumor, most often cervical, vaginal, and endometrial carcinoma.…”

Section: Discussionmentioning

confidence: 99%

Impact of the surgical approach, considering Goh classification, on long-term results in patients with vesicovaginal fistula repair

Mažuran

Hrkac²,

Habek

2022

Afr J Urol

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Background This study aims to present long-term results, preoperative classification, and surgical approach in the therapy of vesicovaginal fistulas (VVF) and neovesicovaginal fistulas (NVVF). Unlike developing countries, where fistulas are mainly the result of delivery trauma, in the modern world, the main causes are urogynecological surgery and irradiation therapy. Methods Data of 36 woman who underwent surgical treatment of VVF and NVVF were collected retrospectively. After clinical assessment, fistulas were categorized by the Goh classification system, which led to the choice of surgical approach: transvaginal or transabdominal. Follow-up period was 60 to 108 months. Results Out of 36 patients evaluated, 23 were operated transabdominal, and 13 were operated transvaginal. Patients selected for the transabdominal approach were mainly categorized as Goh 1 and 2, including patients after radiotherapy and patients with large fistulas. Patients selected for the transvaginal approach were mainly Goh 3 and 4. There were no statistical differences between groups regarding the success of the operation (83.3%) and complication rate. Complications included fistula recurrence (16.6%), stress urinary incontinence (22.2%), urinary tract infections (11.1%), overactive bladder (13.9%), and urosepsis (2.8%). There was a statistical difference in the duration of the hospital stay in favor of the transvaginal approach (12.00 ± 5.8 vs 16.27 ± 4.65). Conclusions Success in the surgical treatment of VVF and NVVF can be achieved by careful preoperative classification, selection of surgical approach, assessment of local tissue status, taking into consideration the characteristics of the fistulas, and adhering to the basic surgical principles. Regardless of the surgical approach, conducting such a preoperative stratification can achieve similar long-term outcomes. Most fistula recurrence (83.3%) appeared within 6 months after the surgery.

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