Transvaginal Approach for Repair of Vesico Vaginal Fistula: An Effective Approach

Abstract

To describe that the transvaginal approach is an excellent route for the repair of vesico vaginal fistula without compromising on success rate. Material and Method: It is a reterospective analysis of 64 cases operated in 10 years. All were operated through transvaginal approach. Study included all supratrigonal, trigonal and infratrigonal fistulas as classified on cystoscopic findings bases. Results: Sixty four patients with vesico vaginal fistula were included in the study. The age of patients was from 20 to 58 years with a mean age of 44.6 years. According to age these were divided into four groups. The cause of vesico vaginal fistula was abdominal hystrectomy in 57 (89.06%) patients while obstructive labour in 7 (10.96%) patients. The size of fistula was further categorized in three groups. The success rate was 87.5% (56 patients) in first attempt while the fistula of remaining 8 patients (12.5%) was successfully repaired in second attempt. Supra trigonal fistula was present in 54 (84.38%) patients while 10 (15.62%) patients had trigonal or infra trigonal fistula. Conclusion: By comparing different approaches, the vaginal approach had a comparable success rate with less morbidity. We suggest, for repair of vesico vaginal fistula, the transvaginal approach should be a preferred approach for a vaginally accessible fistula over tranabdominal approach.