Eight years experience in the surgical management of vesico-vaginal fistula

Aims: to review the aetiology and success of transvaginal repair in simple vesicovaginal fistula cases. objective: to review the aetiology and success of transvaginal three layer repair with delayed absorbable suture material in simple vesicovaginal fistulae cases. design: prospective study. place and duration of study: this study was carried out in dhq hospital,faisalabad over a period of eight years from december 1996 to december 2004. patients and methods: patients were admitted through gynaecology outpatient department. patient's age,socio-economic status,education,nutritional status,obstetrical history,previous history of surgery,i.e.,caesarean section,caesarean hysterectomy,abdominal hysterectomy,vaginal hysterectomy and repair,previous history of vesicovaginal repair were noted. complex fistulae,post-radiation fistulae and fistulae requiring repair other than transvaginal route were excluded from the study. results: during eight years study period sixty patients with a history of true urinary incontinence were confirmed to be patients of simple vesicovaginal fistulae. 52(86.6%) patients developed vesicovaginal fistula after obstructed labour. 4(6.6%) had gynaecological operation as the primary cause for their fistula while the remaining 4(6.6%) resulted from the instrumental delivery by untrained doctors. conclusion: 56(93.2%) patients of vesicovaginal fistulae resulted after obstructed labour and instrumental delivery. vesicovaginal fistula can be successfully managed surgically. standard obstetrical care can reduce such occurrence.