Review of experiences with vesicovaginal fistula repair in 39 cases

Park, Soon Man; Park, Yang Il

Abstract

Vesicovaginal fistula is a distressing complication which may follow total hysterectomy, prolonged labor, chemical cauterization due to uterine prolapse. radiation therapy, and cervix cancer. The management of vesicovaginal fistula still remains controversial in regard to the type of approach and timing of repair. A review of experiences with vesicovaginal fistula repair was done on 39 cases admitted to the Department of Urology, Chonnam University Hospital, during the period from January, 1977 to December. 1991. The most prevalent age group was the forties to fifties (25/39 cases, 64.1%). The most common location of vesicovaginal fistula was the trigone (19/39 cases, 48.7%). The highest range of size of vesicovaginal fistula was that below 1.0 cm (24,39 cases, 61.5%).Of 39 cases. 14 occurred after total hysterectomy (35.9%). 13 chemical cauterization (33.3%). 8 prolonged labor(20.5%). 2 radiation therapy (5.1%). 1 Cesarean section (2.6%), and 1 Dilatation & Curettage (2.6%). The success rate of the initial repair was 88.5% (23,26 cases) by transvaginal repair. 83.3% (5/6 cases) by transperineal transvesical repair. 60.0% (3,5 cases) by suprapubic transvesical repair. 100.0% (1/1 case) by colpotleisis, and l00.0% (1/1 case) by ileal conduit, respectively. The transvaginal repair was most simple, and required the least time of average 96 minutes. Of six cases failed in the initial repair, one case was cured with the second repair and two cases with the third repair, with overall cure rate of 92.3% (36/39 cases).