O’CONOR (TRANSABDOMINAL) REPAIR: IS IT ALWAYS NECESSARY TO INTERPOSE A FLAP IN SIMPLE VESICO-VAGINAL FISTULA? A COMPARATIVE STUDY
Objective: To assess morbidity and success of transabdominal (O’Conor) repair of vesicovaginal fistula with or without interposition of flap between vagina and urinary bladder. Study Design: Prospective comparative study. Place and Duration of Study: Armed Forces Institute of Urology, Rawalpi...
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| Autores principales: | , , , , , , |
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| Formato: | article |
| Lenguaje: | EN |
| Publicado: |
Army Medical College Rawalpindi
2021
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| Materias: | |
| Acceso en línea: | https://doi.org/10.51253/pafmj.v71i1.3599 https://doaj.org/article/7f8d459c2a0144c39937d1f2ced8595d |
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| Sumario: | Objective: To assess morbidity and success of transabdominal (O’Conor) repair of vesicovaginal fistula with or
without interposition of flap between vagina and urinary bladder.
Study Design: Prospective comparative study.
Place and Duration of Study: Armed Forces Institute of Urology, Rawalpindi, from Mar 2016 to Jan 2019.
Methodology: Fifty five patients were randomized into group A & B by lottery method. An inclusion criterion
was single fistulous opening of ≤3cm. Complex and recurrent fistulae were excluded. Patients in group A underwent O’Conor repair without interpositional flap while in group B vesicovaginal fistulae were repaired with flap interposition.
Results: Twenty two patients were randomized in group A while 27 in group B. Mean age of patients was 41.65
± 11.93 years. Gynecological and obstetrical surgery was the main cause of fistula. Mean duration of surgery
was 162.7 ± 18.49 minutes. Per-operative ureteric catheterization was done in 9 (16.8%) patients. Seventeen
(30.6%) patients had paralytic ileus. There was transient fever in 4 (7.6%) of cases and wound infection was seen
in 3 (5.8%) of patients. Mean hospital stay was 3.4 ± 2.3 days. Cystogram was done in 35 (64.5%) of patients before the removal of per-urethral catheter. The overall success rate was 92.9%. Ten (18.2%) of patients developed denovo urgency which was managed conservatively. There was no statistical difference in both groups in terms of morbidity and success.
Conclusion: In simple Vesico-vaginal fistulae repair, interposition of flap can be omitted and it does not affect the outcomes in terms of success and morbidity. |
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