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:	Asma Rizwan, Qamar Zia, Adil Khurshid, Mudassar Sajjad, Muhammad Nawaz, Muhammad Akmal, Faran Kiani
Formato:	article
Lenguaje:	EN
Publicado:	Army Medical College Rawalpindi 2021
Materias:	female urogenital disease urinary bladder fistula vesico-vaginal fistulas Medicine R Medicine (General) R5-920
Acceso en línea:	https://doi.org/10.51253/pafmj.v71i1.3599 https://doaj.org/article/7f8d459c2a0144c39937d1f2ced8595d
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spelling	oai:doaj.org-article:7f8d459c2a0144c39937d1f2ced8595d2021-12-02T19:07:37ZO’CONOR (TRANSABDOMINAL) REPAIR: IS IT ALWAYS NECESSARY TO INTERPOSE A FLAP IN SIMPLE VESICO-VAGINAL FISTULA? A COMPARATIVE STUDYhttps://doi.org/10.51253/pafmj.v71i1.35990030-96482411-8842https://doaj.org/article/7f8d459c2a0144c39937d1f2ced8595d2021-02-01T00:00:00Zhttps://pafmj.org/index.php/PAFMJ/article/view/3599https://doaj.org/toc/0030-9648https://doaj.org/toc/2411-8842Objective: 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.Asma RizwanQamar ZiaAdil KhurshidMudassar SajjadMuhammad NawazMuhammad AkmalFaran KianiArmy Medical College Rawalpindiarticlefemale urogenital diseaseurinary bladder fistulavesico-vaginal fistulasMedicineRMedicine (General)R5-920ENPakistan Armed Forces Medical Journal, Vol 71, Iss 1, Pp 347-350 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	female urogenital disease urinary bladder fistula vesico-vaginal fistulas Medicine R Medicine (General) R5-920
spellingShingle	female urogenital disease urinary bladder fistula vesico-vaginal fistulas Medicine R Medicine (General) R5-920 Asma Rizwan Qamar Zia Adil Khurshid Mudassar Sajjad Muhammad Nawaz Muhammad Akmal Faran Kiani O’CONOR (TRANSABDOMINAL) REPAIR: IS IT ALWAYS NECESSARY TO INTERPOSE A FLAP IN SIMPLE VESICO-VAGINAL FISTULA? A COMPARATIVE STUDY
description	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.
format	article
author	Asma Rizwan Qamar Zia Adil Khurshid Mudassar Sajjad Muhammad Nawaz Muhammad Akmal Faran Kiani
author_facet	Asma Rizwan Qamar Zia Adil Khurshid Mudassar Sajjad Muhammad Nawaz Muhammad Akmal Faran Kiani
author_sort	Asma Rizwan
title	O’CONOR (TRANSABDOMINAL) REPAIR: IS IT ALWAYS NECESSARY TO INTERPOSE A FLAP IN SIMPLE VESICO-VAGINAL FISTULA? A COMPARATIVE STUDY
title_short	O’CONOR (TRANSABDOMINAL) REPAIR: IS IT ALWAYS NECESSARY TO INTERPOSE A FLAP IN SIMPLE VESICO-VAGINAL FISTULA? A COMPARATIVE STUDY
title_full	O’CONOR (TRANSABDOMINAL) REPAIR: IS IT ALWAYS NECESSARY TO INTERPOSE A FLAP IN SIMPLE VESICO-VAGINAL FISTULA? A COMPARATIVE STUDY
title_fullStr	O’CONOR (TRANSABDOMINAL) REPAIR: IS IT ALWAYS NECESSARY TO INTERPOSE A FLAP IN SIMPLE VESICO-VAGINAL FISTULA? A COMPARATIVE STUDY
title_full_unstemmed	O’CONOR (TRANSABDOMINAL) REPAIR: IS IT ALWAYS NECESSARY TO INTERPOSE A FLAP IN SIMPLE VESICO-VAGINAL FISTULA? A COMPARATIVE STUDY
title_sort	o’conor (transabdominal) repair: is it always necessary to interpose a flap in simple vesico-vaginal fistula? a comparative study
publisher	Army Medical College Rawalpindi
publishDate	2021
url	https://doi.org/10.51253/pafmj.v71i1.3599 https://doaj.org/article/7f8d459c2a0144c39937d1f2ced8595d
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O’CONOR (TRANSABDOMINAL) REPAIR: IS IT ALWAYS NECESSARY TO INTERPOSE A FLAP IN SIMPLE VESICO-VAGINAL FISTULA? A COMPARATIVE STUDY

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