*Dr. Savitri and Dr. Sitharamaiah


Background - Obstetric trauma and gynaecological procedures are the most common causes of Vesicovaginal Fistula (VVF) contributing to significant morbidity in the field of female urology.[1] Purpose – To study the cause, characteristics and repair outcomes in patients with VVF in Government based Hospital in rural India. Methodology – Hospital based retrospective cross-sectional study which included 45 patients who were clinically diagnosed with VVF of varied aetiology and underwent surgical repair. Results – Forty Five patients diagnosed with VVF were included in the study. The mean age group of women included in the study was 33.5 years. Majority of cases were secondary to gynaecological surgeries 32(71.1%), rest were due to obstetric trauma 13(28.9%). Majority were simple fistula (less than one cm in diameter) 31(69%) and rest were complex fistula (more than one cm in diameter) 14(31%). All cases underwent repair either by transabdominal approach thirty three(73%), vaginal route ten (22%), laparoscopic approach one (2.2%) and cystoscopic fulguration one(2.2%). 38 cases out of 45(84.4%) had successful closure of fistula with no urinary leakage was noted at end of three months follow up period, seven(16.1%) cases had repair failure. Conclusion – VVF are among the most distressing complication of obstetric trauma and gynaecological surgeries. There is rise in VVF’s secondary to gynaecological surgeries and decline in number of obstetric fistulas reflecting improved intranatal services in India. Simple supratrigonal gynaecological fistulas are best dealt by extraperitoneal transvesical repair.

Keywords: Vesicovaginal fistula, Obstetric trauma, Gynaecological fistula.

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