Clinical relevance and treatment outcomes of vesicovaginal fistula (VVF) after obstetric and gynecologic surgery
Objective: Vesicovaginal fistulas (VVF) are consequences from obstetric and gynecologic surgery. Treatment approach from either abdominal or vaginal route have its own pros and cons. The study aims to present the anatomical, clinical and lower urinary tract symptom outcomes of women with VVF. Materi...
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| Format: | Article |
| Language: | English |
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Elsevier
2019-01-01
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| Series: | Taiwanese Journal of Obstetrics & Gynecology |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S102845591830295X |
| _version_ | 1819298161387110400 |
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| author | Tsia-Shu Lo Sandy Chua Tomy Wijaya Chuan Chi Kao Ma Clarissa Uy-Patrimonio |
| author_facet | Tsia-Shu Lo Sandy Chua Tomy Wijaya Chuan Chi Kao Ma Clarissa Uy-Patrimonio |
| author_sort | Tsia-Shu Lo |
| collection | DOAJ |
| description | Objective: Vesicovaginal fistulas (VVF) are consequences from obstetric and gynecologic surgery. Treatment approach from either abdominal or vaginal route have its own pros and cons. The study aims to present the anatomical, clinical and lower urinary tract symptom outcomes of women with VVF. Materials and methods: A retrospective case series conducted patients with VVF. Data regarding pre-operative evaluation, surgical treatment, and post-operative follow-ups were collected. Surgical approach depended on the cause, type, number, size, location, and time of onset of the fistula. Post-operatively, foley catheter was maintained for at least 1 week with cystoscopy performed prior to removal. Follow-up evaluation included cystoscopy, bladder diary, UDI-6 and IIQ-7 questionnaires and multi-channel urodynamic study. Results: Of the 15 patients that were evaluated, 1 had spontaneous closure, 8 were repaired vaginally and 6 abdominally. Patients repaired vaginally were significantly noted to have a mean age of 50.3 ± 7.1 years with VVFs located adjacent the supra-trigone area having a mean distance of 1.7 ± 0.5 cm from the ureteric orifice. Its operative time and hospital stay were significantly shorter. In contrast, abdominally repaired patients had mean age of 38.0 ± 8.2 years and VVFs with mean distance of 0.4 ± 0.4 cm from the ureteric orifice. Post-operatively, 2 cases (14.2%, 2/14) of VVF recurrence and de novo urodynamic stress incontinence (USI) (25%, 2/8) were noted after vaginal repair and 3 cases (50%, 3/6) of concurrent ureteric injury and overactive bladder after abdominal repair. Conclusion: Treatment outcomes for vaginal and abdominal repair yielded good results. Though the vaginal route had higher incidence of recurrence and de novo USI, its less invasiveness, faster recovery period, and no association with post-op overactive bladder made it more preferable than the abdominal approach. Keywords: Vesicovaginal fistula, Vaginal repair, Abdominal repair, Surgical outcomes, Lower urinary tract symptoms |
| first_indexed | 2024-12-24T05:25:30Z |
| format | Article |
| id | doaj.art-a65c207b07bf4f8ab38e97fb50b4f2f9 |
| institution | Directory Open Access Journal |
| issn | 1028-4559 |
| language | English |
| last_indexed | 2024-12-24T05:25:30Z |
| publishDate | 2019-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Taiwanese Journal of Obstetrics & Gynecology |
| spelling | doaj.art-a65c207b07bf4f8ab38e97fb50b4f2f92022-12-21T17:13:20ZengElsevierTaiwanese Journal of Obstetrics & Gynecology1028-45592019-01-01581111116Clinical relevance and treatment outcomes of vesicovaginal fistula (VVF) after obstetric and gynecologic surgeryTsia-Shu Lo0Sandy Chua1Tomy Wijaya2Chuan Chi Kao3Ma Clarissa Uy-Patrimonio4Department of Obstetrics and Gynaecology, Chang Gung Memorial Hospital, Keelung Medical Center, Keelung, Taiwan, Republic of China; Division of Urogynaecology, Department of Obstetrics and Gynaecology, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan, Republic of China; Chang Gung University, School of Medicine, Taoyuan, Taiwan, Republic of China; Corresponding author. Department of Obstetrics and Gynaecology, Chang Gung Memorial Hospital Keelung, Keelung Medical Centre, 222, Maijin Road, Keelung 204, Taiwan, Republic of China. Fax: 886 3 3288252.Fellow, Division of Urogynaecology, Department of Obstetrics and Gynaecology, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan, Republic of China; Department of Obstetrics and Gynecology, Cebu Velez General Hospital, Cebu City, PhilippinesDepartment of Obstetrics and Gynecology, H. Adam Malik General Hospital, North Sumatra University, Medan, IndonesiaDepartment of Obstetrics and Gynaecology, Chang Gung Memorial Hospital, Keelung Medical Center, Keelung, Taiwan, Republic of ChinaFellow, Division of Urogynaecology, Department of Obstetrics and Gynaecology, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan, Republic of China; Department of Obstetrics and Gynecology, Dr. Pablo O. Torre Memorial Hospital, Bacolod City, PhilippinesObjective: Vesicovaginal fistulas (VVF) are consequences from obstetric and gynecologic surgery. Treatment approach from either abdominal or vaginal route have its own pros and cons. The study aims to present the anatomical, clinical and lower urinary tract symptom outcomes of women with VVF. Materials and methods: A retrospective case series conducted patients with VVF. Data regarding pre-operative evaluation, surgical treatment, and post-operative follow-ups were collected. Surgical approach depended on the cause, type, number, size, location, and time of onset of the fistula. Post-operatively, foley catheter was maintained for at least 1 week with cystoscopy performed prior to removal. Follow-up evaluation included cystoscopy, bladder diary, UDI-6 and IIQ-7 questionnaires and multi-channel urodynamic study. Results: Of the 15 patients that were evaluated, 1 had spontaneous closure, 8 were repaired vaginally and 6 abdominally. Patients repaired vaginally were significantly noted to have a mean age of 50.3 ± 7.1 years with VVFs located adjacent the supra-trigone area having a mean distance of 1.7 ± 0.5 cm from the ureteric orifice. Its operative time and hospital stay were significantly shorter. In contrast, abdominally repaired patients had mean age of 38.0 ± 8.2 years and VVFs with mean distance of 0.4 ± 0.4 cm from the ureteric orifice. Post-operatively, 2 cases (14.2%, 2/14) of VVF recurrence and de novo urodynamic stress incontinence (USI) (25%, 2/8) were noted after vaginal repair and 3 cases (50%, 3/6) of concurrent ureteric injury and overactive bladder after abdominal repair. Conclusion: Treatment outcomes for vaginal and abdominal repair yielded good results. Though the vaginal route had higher incidence of recurrence and de novo USI, its less invasiveness, faster recovery period, and no association with post-op overactive bladder made it more preferable than the abdominal approach. Keywords: Vesicovaginal fistula, Vaginal repair, Abdominal repair, Surgical outcomes, Lower urinary tract symptomshttp://www.sciencedirect.com/science/article/pii/S102845591830295X |
| spellingShingle | Tsia-Shu Lo Sandy Chua Tomy Wijaya Chuan Chi Kao Ma Clarissa Uy-Patrimonio Clinical relevance and treatment outcomes of vesicovaginal fistula (VVF) after obstetric and gynecologic surgery Taiwanese Journal of Obstetrics & Gynecology |
| title | Clinical relevance and treatment outcomes of vesicovaginal fistula (VVF) after obstetric and gynecologic surgery |
| title_full | Clinical relevance and treatment outcomes of vesicovaginal fistula (VVF) after obstetric and gynecologic surgery |
| title_fullStr | Clinical relevance and treatment outcomes of vesicovaginal fistula (VVF) after obstetric and gynecologic surgery |
| title_full_unstemmed | Clinical relevance and treatment outcomes of vesicovaginal fistula (VVF) after obstetric and gynecologic surgery |
| title_short | Clinical relevance and treatment outcomes of vesicovaginal fistula (VVF) after obstetric and gynecologic surgery |
| title_sort | clinical relevance and treatment outcomes of vesicovaginal fistula vvf after obstetric and gynecologic surgery |
| url | http://www.sciencedirect.com/science/article/pii/S102845591830295X |
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