vesicovaginal fistula: characteristics, diagnosis, and management at dr. soetomo hospital in three years (2020-2022)

Background objective: vesicovaginal fistulas (vvf) have become rare in the industrialized world, but they still commonly occur in developing countries. this research aims to explore the incidence, diagnosis, management, and outcomes of vvfs.materials methods: in a retrospective study, demographic and clinical data were obtained for all women with vvfs at dr. soetomo hospital between january 2020 and december 2022 using medical record.results: the total number of patients was 47; the age ranged from 16 to 69 years with a mean of 42 (±6) years and 41-50 years (40.42%), with parity 0-vi. the etiology of vvfs was obstetric (8 patients, 17.02%), surgical (20 patients, 42.55%), malignancy (18 patients, 38.29%), and miscellaneous (1 patient, 2.12%). most obstetric etiologies were prolonged obstructed labor (50%), 37.5% of cases followed the caesarean section, and 12.5% followed instrumental delivery with forceps. all the vvf cases are performed in the cystoscopy examination based on medical record. most patients (28 cases, 59.57%) had a complex fistula with 0.50-2.5cm in diameter, and the position was mostly high fistula, near the cervix. a total of 22 patients (46.80%) have been repaired, while 11 patients with malignancy (23.40%) still waited until 12 months after chemoradiation, and 14 patients (29.78%) in conservative management were observed until a 3-month post-surgical procedure. one patient of the fistula repair had failed one month after the first repair.conclusion: patients have various causes of fistula and are caused by complications of childbirth. treatment is adjusted to the severity of the fistula experienced and the prognosis that occurs also differs in opportunities between patients.