SURGICAL TREATMENT OF VESICOVAGINAL FISTULA; AN AUDIT OF 69 CASES

Objective: the aim of this study is to assess the outcome of patients undergoing repair of vesicovaginalfistula.methodology: this descriptive study which was conducted from may 2002 to march 2008 the departmentof urology lady reading hospital peshawar. a total of 69 patients with vesicovaginal fistula wereincluded in this study. a detailed history and physical examination with special emphasis on previousgynecological and obstetrical events was recorded. all these patients underwent routine investigations likehb%, cbc, urianalysis, renal function test and viral profile with ultrasonography of the abdomen &pelvis. intravenous urography(ivu) was offered to those patients who had upper tract dilatation onultrasonography. preliminary cystoscopy and vaginoscopy was performed in all patients to diagnose vvfand plan the surgical approach.result: the mean age was 39.07(+10.031)years. thirt eight (55%) patients developed fistula due toobstetrical reasons while 30 (43-47%) had gynaecological surgeries and only one patient developed fistulaafter radiotherapy. the average size of the fistula was 3.36 cm: transabdominal repair of fistula was donein 58(84.1%) patients while 11(15.9%) has transvaginal repair. successful repair was achieved in65(93.7%) patients.conclusion: vesicovaginal fistula can be successfully managed surgically. proper preoperative assessmentof the patients is mandatory for selection of the surgical approach