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- Title
Clinical application of single-layer annular vaginal flap in transvaginal repair for vesicovaginal fistula.
- Authors
Tang, Min; Li, Pu; Wang, Chengming; Zhang, Qian; Meng, Xiaoxin
- Abstract
Purpose: To compare the first-time success rate and prognosis of repairing vesicovaginal fistula (VVF) by transvaginal and transvesical approaches, and to highlight a modified transvaginal repair technique which only require single layer closure of an annular vaginal flap. Methods: Retrospective analysis of 57 consecutive patients who underwent VVF repair between 2007 and 2021. Fistula characteristics, operative factors, post-surgical complications and outcomes were analyzed. Results: A total of 57 women with a median age of 50.4 (27–75) years were included. The history ranged from 7 days to 8 years, with an average of 20 months. 56 cases (98.2%) of VVFs were caused by pelvic surgery, and only one resulted from difficult labour. 11 cases (19.3%) had a history of surgical repair failure. All 57 cases of surgery were smoothly completed. Among them, 17 patients underwent transvaginal repair, whereas 40 (70.2%) women had transvesical repair. Transvaginal approach had a significantly shorter operative time, less intraoperative blood loss, reduced postoperative hospital stay, less hospitalization cost and lower minor complication rates than transvesical group (p < 0.05). No serious complications occurred in the two groups. No cystostomy was performed in the transvaginal group, but 12 cases (30%) in the transvesical group. The average follow-up time was 18.5 (3–48) months. The first-time success rates of transvaginal and transvesical techniques were 82.3 and 75%, respectively. Conclusion: VVF repair with single layer closure of an annular vaginal flap is a technically feasible, simple and successful approach with significantly better operative parameters and lower complications rates.
- Subjects
VESICOVAGINAL fistula; CLINICAL medicine; SURGICAL blood loss; INTRAVESICAL administration; SURGICAL complications; VAGINAL medication; CYSTOSTOMY
- Publication
World Journal of Urology, 2023, Vol 41, Issue 1, p249
- ISSN
0724-4983
- Publication type
Article
- DOI
10.1007/s00345-022-04222-w