title: Factors Influencing Repair Outcomes of Vesicovaginal Fistula: A Retrospective Review of 139 Procedures.
abstract: BACKGROUND
  We aimed to report the outcomes of patients undergoing vesicovaginal fistula (VVF) repair to identify prognostic factors.
  
  
  METHODS
  Patients who underwent VVF repair between January 2009 and October 2015 were reviewed. Primary outcome was fistula closure at 3 months.
  
  
  RESULTS
  A total of 123 patients and 139 procedures of VVF repair were reviewed. The overall success rate was 85.6%. There were no significant differences in age (p = 0.476), etiology (p = 0.900), fistula duration (p = 0.491) and number of repairs (p = 0.509) between success and fail group. Moderate or severe perifistula fibrosis and multiple fistula were associated with failure in repair of fistula (70.8 vs. 93.4%, p < 0.001; 62.5 vs. 88.6%, p = 0.005). No difference was seen in success rate of vaginal and abdominal approaches (86.0 vs. 85.0%, p = 0.800). Logistic regression analysis identified fistula number (p = 0.003) and perifistula fibrosis (p = 0.002) as 2 independent prognostic factors. Medium/large fistulas were 3.2 times more likely to fail in repair than small fistulas (OR 3.2, 95% CI 0.95-10.6, p = 0.061).
  
  
  CONCLUSIONS
  Fistula number and perifistula fibrosis were 2 independent prognostic factors for fistula repair. Unsuccessful closure was more likely in medium/large VVF.
authors.affiliation: Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, PR China.
authors.forename: Liang
authors.initials: L
authors.lastname: Zhou
authors.forename: Tong-Xin
authors.initials: TX
authors.lastname: Yang
authors.forename: De-Yi
authors.initials: DY
authors.lastname: Luo
authors.forename: Shu-Lian
authors.initials: SL
authors.lastname: Chen
authors.forename: Bang-Hua
authors.initials: BH
authors.lastname: Liao
authors.forename: Hong
authors.initials: H
authors.lastname: Li
authors.forename: Kun-Jie
authors.initials: KJ
authors.lastname: Wang
authors.forename: Hong
authors.initials: H
authors.lastname: Shen
mesh_terms: D000328:Adult; D000368:Aged; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D016015:Logistic Models; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D011183:Postoperative Complications / Q000209:etiology; D012189:Retrospective Studies; D012307:Risk Factors; D013524:Surgical Flaps / Q000009:adverse effects; D013997:Time Factors; D016896:Treatment Outcome; D013520:Urologic Surgical Procedures / Q000009:adverse effects; D014719:Vesicovaginal Fistula / Q000175:diagnosis / Q000601:surgery*; D055815:Young Adult
keywords: Fistula; Prognostic; Repair; Vesicovaginal