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Vesicovaginal fistulas (VVFs) are the most commonly acquired fistulae of the urinary tract.
Two VVFs with obstetric etiologies were managed using abdominal excision and repair.
In this retrospective study, we evaluated only the surgical approach for the management of VVFs; therefore, patients who were conservatively treated were out of the scope of this study.
In a recent report from Turkey, outcomes of 53 cases with VVFs were discussed and none of the fistula closed with conservative management (8).
However, the follow-up was 84 to 99 days, nearly 20% of the patients had a degree of genital mutilation; there was extensive scarring in 7.7% of patients operated via vaginal route versus 3.5% of patients operated via the abdominal route, only 3.69% of the patients underwent abdominal surgery, and finally the population comprised VVFs and all types of genitourinary fistulas (16).
Despite the proven long-term results of the vaginal approach for VVFs, there is a tendency in our clinic to perform abdominal repairs, especially for cases that urologists perform.
Four patients had surgical site infections leading to breakdown of vesicovaginal fistula (VVF) repair; 4 cases of post-operative urinary tract infection (UTI) were successfully treated with intravenous antibiotics.
For descriptive purposes OUFs were categorised into simple VVF, complicated VVF, and vesico-uterine fistulas.
Three of the 4 women with VVF and 1 with uretero-uterine fistula noticed urinary incontinence 6 weeks after CS.
Four women presented with VVF and 1 with ureterouterine vaginal fistula following CS.
Accordingly, the workup of the VVF should begin with a thorough cystoscopic evaluation of the bladder, with retrograde pyelography to evaluate the integrity of the ureters bilaterally.
I have described a systematic approach to robotic VVF repair.
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- Vvedenskii, Aleksandr
- Vvedenskii, Aleksandr Ivanovich
- Vvedenskii, Boris
- Vvedenskii, Boris Alekseevich
- Vvedenskii, Nikolai
- Vvedenskii, Nikolai Evgenevich