Nondelayed transvaginal repair of high lying vesicovaginal fistula.
The management of vesicovaginal fistula still remains controversial in regard to the timing of repair and type of approach. A total of 16 patients underwent transvaginal repair of simple nonradiated vesicovaginal fistulas. In 7 patients the repairs were less than 3 months after the injury, while in 9 the delay was greater than 3 months. A total of 14 patients had high lying lesions (fistulas above the trigone) and 2 had low lying lesions (fistulas below the trigone). Of the 16 patients 15 (94%) stopped leaking after a transvaginal repair. All 7 patients with high lying lesions who underwent operative repair less than 3 months after injury were dry. We advocate early nondelayed repair of high and low lying simple nonradiated vesicovaginal fistulas using the transvaginal approach. The customary waiting period of 3 to 6 months before repair may not be warranted.
Wang
Y
Y
Department of Urology, Loma Linda University Medical Center, California.
Hadley
H R
HR
D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007044:Hysterectomy / Q000009:adverse effects; D008722:Methods; D008875:Middle Aged; D012086:Reoperation; D012189:Retrospective Studies; D013997:Time Factors; D014719:Vesicovaginal Fistula / Q000209:etiology / Q000473:pathology / Q000601:surgery*