Vesicovaginal fistulas: Results of surgical treatment during ten years

Abstract

Introduction. Vesicovaginal fistulas (VVF) are the most common and the most frequent type of urogenital fistulas. They may have a different etiology. In most cases, surgery is required for treatment. Objective. The aim of the study was to analyze the results of surgical therapy of VVF in a tertiary level institution over the last decade. Methods. The retrospective study of results was conducted involving a total number of 99 women who were surgically treated for VVF at the Clinic of Urology of the Clinical Center of Serbia in Belgrade in the period from 2001?2010. Results. Over the past ten years VVF occurred after hysterectomy in 74.7% of cases, and almost twice more frequently after hysterectomy for a benign gynecological disease. In the surgical treatment of primary VVF transvesical approach was used in 53.53% (52/99) of cases. Relapses were treated surgically using transperitoneal approach in all cases. No significant difference was found in respect to the applied approach in the surgical treatment of primary fistulas. In even 94% (93/99) of cases the problem of VVF was solved by a single surgical intervention only. In total, in 107 interventions 8 (7.4%) relapses were recorded. Conclusion. The study showed that VVF occurred after hysterectomy in three quarters of cases, more frequently after hysterectomy due to a benign gynecological disease. Early detection with timely and appropriate treatment of gynecological diseases will reduce the number of conditions that may lead to VVF. Surgical treatment of VVF yielded satisfactory results; it was shown that even in 94% of cases the problem of VVF was solved by a single surgical intervention only, however further improvement is certainly necessary.