1. Majeed Ullah Buzdar 2. M. Amjad Khan 3. Naz Akhtar

1. Asstt. Prof. of Surgery, Ghazi Khan Medical College DG. Khan, 2,3. Asstt. Profs., MMDC, Multan

ABSTRACT

Objective: To evaluate the results of surgical repair of VVF through transabdominal and transvaginal routes.

Study Design: Prospective study

Place and Duration of Study: This study was carried out in Teaching Hospital, Ghazi Khan Medical College, DG Khan from June 2009 to May 2014.

Patients and Methods: Total 26 patients of VVF  with age range of 22-60 years were included in the study. Fistulas had two types, simple and complex, according to site, size and aetiology . Simple VVFs were repaired through the vaginal route and complex ones through abdominal route. Patients were assessed at an  interval of two to three weeks to start with , twice after three-months and thereafter depending on complaints.

Results: Sixteen (61%) patients had simple fistulas, while 10 (38%) patients had complex fistulas and one of the patients had complex fistula associated with rectal communication who was excluded . The most common cause was trauma during obstructed labour in 12(47%) patients, whereas the other common cause was hysterectomy .Sixteen(61%) patients were approached through transvaginal route, out of them 9 had supratrigonal and 7 trigonal fistulas. Ten (38%) patients with complex fistulas were approached by abdominal route. Duration of the surgery, blood loss,  pain  after surgery and stay in hospital was found to be shorter in transvaginal surgery. Two patients have failed repair with significant complications, a success rate of 92% was achieved . At a follow-up of one year 24 women had uneventful, active sexual life while 2 of them had some degree of pain during  sexual intercourse

Conclusion: It’s concluded that both the routes of VVF repair has a similar success rate 

Key Words: Vesicovaginal, Fistula, Simple, Complex, Management

Citation of article: Buzdar MU, Khan MA, Akhtar N. Transabdominal and Transvaginal Repair of