Comparison of the Abdominal and Transvaginal Techniques in the Surgical Treatment of Vesicovaginal Fistula and Analyzing the Factors Affecting Its Recurrence

Abstract

Objective:To compare the abdominal and transvaginal techniques in the surgical treatment of vesicovaginal fistula (VVF) and analyze the factors affecting its recurrence rate.Materials and Methods:Patients were divided into two groups according to the operation technique used (abdominal-transvaginal) and the recurrence status (recurrent and non-recurrent). The primary endpoint of the study was the comparison of the factors related to fistula and surgical techniques.Results:The number of cases with radiotherapy history was found to be higher in the recurrent group (68.2% vs 11.5%, p<0.001). Although fistulas were more subtrigonally located in the transvaginal repair group, the supratrigonal localization was more frequent in those operated with abdominal technique (p=0.019). While the rates of first and second recurrences were more in the cases managed by the transvaginal technique (p=0.041), the length of hospitalization and the mean operation time were longer in women managed by abdominal technique (p=0.025 and p=0.019, respectively).Conclusion:The abdominal technique provides more favorable outcomes by allowing extensive tissue exposure and omental tissue flep in the surgical treatment of VVF. Patients with a history of radiotherapy are more likely to have a recurrence after the surgery and repetitive treatment may be needed.

Keywords

• vesicovaginal fistula
• vesicovaginal fistula repair
• gynecological trauma
• transvaginal technique
• abdominal technique