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

ABSTRACT Background: Vesicovaginal fistulae (VVF) inflicts a significant deal of physical as well as physiological aspect on the patients and is considered as one of the mortifying conditions that affect women. Aim: This study aims to review our experience in the management of VVF over six years, 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. The successful repair was defined as the absence of urine leakage per vaginal on follow up. Results: A total of 20 patients over six 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 most prevalent 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. KEYWORDS vesicovaginal, fistulae, repair, transabdominal, transvaginal