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The management of vesicovaginal fistulae at Urology Division, Sanglah Hospital, Bali

Kadek Budi Santosa, Ida Bagus Putra Pramana, Pande Made Wisnu Tirtayasa, I Wayan Yudiana, Gede Wirya Kusuma Duarsa, Anak Agung Gde Oka.

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Background: Vesicovaginal fistulae (VVF) inflicts a major deal of physical as well as physiological aspect on the patients and is considered as one of the most mortifying conditions that affect women.
Aim: The aim of this study is to review our experience in the management of VVF over a 6-year period, with an emphasis on causes, treatment modalities and outcomes.
Methods: From January 2013 to June 2018 all patients with VVF resulting from causes other than advances malignancies who underwent repair surgery were included in the study. The surgery techniques are being transvaginal with or without Martius flap and transabdominal with open or laparoscopy. Successful repair was defined as the absence of urine leakage per vaginal on follow up.
Results: A total of 20 patients over 6 years period were included in this study. Most of the cases occurred at aged 40-49 years (45%), multipara (95%) and came from the middle socio-economic strata (75%). Hysterectomy was the commonest cause of fistulae (75%) and mid-vaginal fistulae being the most form of fistulae found (65%). Most of them treated with the transvaginal approach (75%). The overall success rate of all the procedures were 80% at the primary repair.
Conclusion: Despite the impressive outcome of surgical repairs, emphasis should be shifted towards the prevention of this dehumanizing condition which could be achieved through proper enlightenment of the populace and general improvement in the quality of surgical service.

Key words: vesicovaginal, fistulae, repair, transabdominal, transvaginal

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