VESICO-VAGINAL FISTULAE;

Abstract

Objectives: To review the causes, diagnosis and treatment of vesico-vaginalfistulae in the department of Gynaecology& Obstetrics, and Urology Department Civil HospitalQuetta. Background: Vesico-vaginal fistula is not life threatening medical disease, but the womanface problems like demoralization, isolation, social boycott and even divorce. The etiology ofthe condition has been changed over the years and in developed countries obstetrical fistulaare rare and they are usually result of gynecological surgeries or radiotherapy. In countrieslike Pakistan the situation is different, here literacy rate is low, parity rate is high and medicalfacilities are deficient. People manage delivery at home and usually multi parity. Urogenital fistulasurgery doesn’t require special or advance technology but needs experienced urogynecologistwith trained team and post operative care which can restore health, hope and sense of dignityto women. Methods: A retrospective study of 60 patients with different types of vesico-vaginalfistula werereviewed between January 2005 to December 2008. Patients were analyzed withregard to age, parity, cause, diagnosis, mode of treatment and outcome. Patients were alsoevaluated initially according to prognosis. Results: During the study of four year period 60patients of vesico-vaginal fistulae were reviewed. Majority of the patients were belonging tomiddle age group. In 48 patients repair was done through transvaginal route and 12 wereoperated through transabdominal route. One Ca patient expired and in 4 patients recurrenceoccurred. Conclusions: Iatrogenic vesico-vaginal fistulae are more common. Difficult andcomplicated fistulae need experienced surgeon. Establishment of separate fistula surgery unitis suggested to get desired results.