title: Transvaginal repair of complex and complicated vesicovaginal fistulae.
abstract: OBJECTIVE
  To document the experience at a tertiary referral hospital in India with managing complex and complicated vesicovaginal fistulae (VVF) by the transvaginal route, and to document the complications and the long-term outcome of the patients.
  
  
  METHODS
  The medical records of 102 patients with complex or complicated VVF who underwent transvaginal surgical repair during 2000-2009 were reviewed retrospectively.
  
  
  RESULTS
  The mean age of the patients was 24 years and the mean duration of urinary incontinence was 3 years (range 6 months to 12 years). The patients were followed up for a median of 48 months. In total, 78 patients had obstetric fistulae, 20 patients had surgical (gynecologic) fistulae, and 4 patients had postradiation fistulae. The overall success rate for the transvaginal approach was 86.3%. Fourteen patients remained incontinent despite the surgical repair. Early failure of the repair was observed in 11.8% of the patients and delayed failure in 2.0%. Postoperative complications included stress urinary incontinence (9.8%), urge urinary incontinence (7.8%), dyspareunia (5.9%), and chronic labial pain (2.0%).
  
  
  CONCLUSIONS
  The transvaginal approach to the repair of complex and complicated VVF gives good long-term results with low complication rates.
authors.affiliation: Department of Urology, Chhatrapati Shahuji Maharaj Medical University formerly King George's Medical University, Lucknow, India.
authors.forename: Vishwajeet
authors.initials: V
authors.lastname: Singh
authors.forename: Rahul J
authors.initials: RJ
authors.lastname: Sinha
authors.forename: Satya N
authors.initials: SN
authors.lastname: Sankhwar
authors.forename: Seema M
authors.initials: SM
authors.lastname: Sinha
authors.forename: Priti
authors.initials: P
authors.lastname: Vatsal
authors.forename: Vaishali
authors.initials: V
authors.lastname: Jain
mesh_terms: D000293:Adolescent; D000328:Adult; D004414:Dyspareunia / Q000453:epidemiology / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007194:India; D010146:Pain / Q000453:epidemiology / Q000209:etiology; D011183:Postoperative Complications / Q000453:epidemiology*; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D014549:Urinary Incontinence / Q000453:epidemiology / Q000209:etiology*; D014719:Vesicovaginal Fistula / Q000150:complications / Q000209:etiology / Q000601:surgery*; D055815:Young Adult