title: Comparative analysis of outcome between laparoscopic versus open surgical repair for vesico-vaginal fistula.
abstract: OBJECTIVE
  Vesicovaginal fistula (VVF) causes detrimental psychosomatic effects on a woman. It is repaired using open abdominal as well as laparoscopic approach. Here we compare a series of open versus laparoscopic VVF repairs done at a single centre.
  
  
  METHODS
  Retrospectively data of patients undergoing VVF repair in our department between January 2011 to December 2014 was analyzed. Patients who had a single, primary, simple VVF following a gynaecological surgery were included in the study. 26 patients met all the criteria. Out of these, thirteen patients had undergone a laparoscopic VVF repair (group 1) while thirteen had undergone an open transabdominal VVF repair (group 2).
  
  
  RESULTS
  Mean fistula size was 2.14±0.23 cm in group 1 and 2.18±0.30 cm in group 2, which was comparable. Mean blood loss was 58.69±6.48 mL in group 1 and 147.30±19.24 mL in group 2, which is statistically significant (P<0.0001). Mean hospital stay was 4 days in group 1 and 13 days in group 2 which is statistically significant (P<0.0001). The analgesic requirement (diclofenac) was 261.53±29.95 mg in group 1 and 617.30±34.43 mg in group 2, which is statistically significant (P<0.0001). Fistula repair was successful in all the patients in both the groups.
  
  
  CONCLUSIONS
  The present study shows that laparoscopic VVF repair results in reduced patient morbidity and shorter hospital stay without compromising the results. So laparoscopic repair may be a more attractive treatment option for patients with post gynecology surgery VVF.
authors.affiliation: Department of Urology, Institute of Postgraduate Medical Education & Research, Kolkata, India.
authors.forename: Bastab
authors.initials: B
authors.lastname: Ghosh
authors.affiliation: Department of Urology, Institute of Postgraduate Medical Education & Research, Kolkata, India.
authors.forename: Varun
authors.initials: V
authors.lastname: Wats
authors.affiliation: Department of Urology, Institute of Postgraduate Medical Education & Research, Kolkata, India.
authors.forename: Dilip Kumar
authors.identifier: 0000-0002-7048-9812
authors.initials: DK
authors.lastname: Pal
keywords: Laparoscopy; Open surgery; Vesicovaginal fistula