Obstetric Fistula Repair Through Transvaginal Approach: The Experience in DMCH

Abstract

Background: Vesicovaginal fistula (VVF) is an abnormal fistulous tract extending between the bladder and the vagina that allows the continuous involuntary discharge of urine into the vaginal vault. The successful closure depends on many factors, although the majority of genitourinary fistulas can be closed surgically. Aim of the study: The aim of the study was to find out the outcome of obstetric fistula repair through a transvaginal approach. Methods: This prospective observational study was conducted in the Department of Gynecology & Obstetrics, Dhaka Medical College Hospital Dhaka, Bangladesh from June 2006 to May 2007. A total of 30 women with VVF difficulties who were admitted to the hospital were recruited as the study population. To repair the obstetrics fistula of women, the transvaginal surgical procedure was followed. For data analysis, statistical software SPSS version 22.0. All data were presented in mean values. The results were presented in tables, figures. The observations were recorded as statistically significant (p-value <0.05). Results: Postoperative complications were not found in 28 (93.3%) cases and no information was found in 2 (6.7%). Duration of retaining catheter (days) <10 in 1 (3.3%), 10-15 in 19 (63.3%), 16-21 in 8 (26.7%) and no information found in 2 (6.7%). Total length of stay (week) was 3-4 week in 13 (43.3%), 5-8 week in 10 (33.3%), 9-12 in 3 (10.0%), 13-24 in 4 (13.4%). The patient developed stress incontinence in 8 (26.7%) and no information was found in 22 (73.3%). 20 (66.7%) cases resulted successfully, Stress incontinence was found in 3 (10.0%), failed VVF in 1 (3.3%), Failed RVF in 6 (20.0%). The reason for failure was 2 (6.7%) bad cases and no information was found in 28 (93.3%). Conclusion: The transvaginal approach is less invasive and achieves comparable success rates as compared to other methods of VVF repair. Genital fistula repair surgery with Foley catheter has a high success rate, reduced morbidity, minimal blood loss, and short tome hospital stay.