DOI: 10.36347/sjams.2021.v09i12.024

Pages: 1919-1923

Background: Vesico-vaginal fistula (VVF) is a distressing condition with significant social and health consequences for women, particularly in developing countries. The study conducted at Dhaka Medical College Hospital, Bangladesh, aimed to analyze the characteristics, management, and outcomes of VVF repair in a tertiary care setting and to explore the factors contributing to the success rates of surgical interventions. Methodology: For the current study, a descriptive approach was employed, examining 72 vesicovaginal fistula repairs at Dhaka Medical College Hospital's Obstetrics and Gynaecology Department over a two-year period, from January 2007 to December 2008. The cohort consisted of patients with prior unsuccessful VVF repair attempts, deliberately excluding cases with additional complications such as rectovaginal fistulas or those who declined participation. Preoperative evaluations were systematically conducted, followed by surgical repairs under regional anesthesia, with general anesthesia reserved for specific indications. Surgical protocol dictated careful dissection and mobilization techniques, with intraoperative dye tests ensuring fistula closure integrity, and the use of labial or omental grafts as necessary. Postoperative care included absorbable sutures for vaginal closure, catheterization, and hemostatic vaginal packing. The postoperative regimen addressed potential complications and included detailed follow-up consultations, focusing on a range of urogenital and reproductive health indicators. Result: The majority of the patients fell within the age range of 31-35 years (25%), and 43.06% were primiparous. Preoperative complications included vaginal stenosis and urethral avulsion (18.06% each). Surgical repairs were mainly single-layer closures (90.28%), with a significant proportion utilizing labial fat grafts (38.89%). Post-operative complications were observed, with catheter blockage (33.33%) and urine leakage (30.56%) being the most common. ...