Vaginal repair of supratrigonal vesicovaginal fistulae--a 10-year review.
OBJECTIVE
A 10-year retrospective study was done to determine the outcome of vaginal repair for supratrigonal vesicovaginal fistulae (VVF).


METHODS
One hundred thirty-two urinary fistulae were managed from 2001 to 2011 which include 34 ureterovaginal and 98 lower urinary tract fistulae. Fifty-three out of 98 were supratrigonal VVF, 49 were of benign etiology and 4 were malignancy induced. Further analysis of 49 supratrigonal VVF of benign etiology revealed that 38 (77.5%) were of gynecological origin and 11 (22.5%) obstetric. Forty-three were primary and six were recurrent VVF. Thirty (61.2%) supratrigonal VVF were repaired vaginally and 19 (38.8 %) abdominally. Mean follow-up period was 51.7 months.


RESULTS
The successful outcome for vaginal and abdominal repair was 86.7% and 100%, respectively (p value = 0.26). Overall, 91.8% supratrigonal VVF were cured at our first attempt.


CONCLUSIONS
Majority of supratrigonal VVF can be approached vaginally with success rate comparable to abdominal approach.
Department of Urogynecology, Government Kasturba Gandhi Hospital & Institute of Social Obstetrics, Madras Medical College, Trilplicane, Chennai 600005, India. dr_nrm@sify.com
N
N
Rajamaheswari
Archana
A
Bharti
K
K
Seethalakshmi
D005260:Female; D006801:Humans; D013519:Urogenital Surgical Procedures / Q000379:methods; D014621:Vagina / Q000601:surgery*; D014719:Vesicovaginal Fistula / Q000473:pathology / Q000601:surgery*