O’CONOR (TRANSABDOMINAL) REPAIR: IS IT ALWAYS NECESSARY TO INTERPOSE A FLAP IN SIMPLE VESICO-VAGINAL FISTULA? A COMPARATIVE STUDY

  • Asma Rizwan Combined Military Hospital Lahore/National University of Medical Sciences (NUMS) Pakistan
  • Qamar Zia Combined Military Hospital Lahore/National University of Medical Sciences (NUMS) Pakistan
  • Adil Khurshid Combined Military Hospital Lahore/National University of Medical Sciences (NUMS) Pakistan
  • Mudassar Sajjad Combined Military Hospital Malir/National University of Medical Sciences (NUMS) Pakistan
  • Muhammad Nawaz Armed Forces Institute of Urology/National University of Medical Sciences (NUMS) Rawalpindi Pakistan
  • Muhammad Akmal Combined Military Hospital Malir/National University of Medical Sciences (NUMS) Pakistan
  • Faran Kiani Armed Forces Institute of Urology/National University of Medical Sciences (NUMS) Rawalpindi Pakistan
Keywords: Female urogenital disease, Urinary bladder fistula, Vesico-vaginal fistulas

Abstract

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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Author Biography

Qamar Zia, Combined Military Hospital Lahore/National University of Medical Sciences (NUMS) Pakistan

MBBS, MRCS (Ed), FCPS (Pak), FRCS (Eng), FRCS ( Urol)

Leutenant Colonel and Assistant professor of Urology

Combined Military Hospital Lahore

 

Published
2021-02-25
How to Cite
Rizwan, A., Zia, Q., Khurshid, A., Sajjad, M., Nawaz, M., Akmal, M., & Kiani, F. (2021). O’CONOR (TRANSABDOMINAL) REPAIR: IS IT ALWAYS NECESSARY TO INTERPOSE A FLAP IN SIMPLE VESICO-VAGINAL FISTULA? A COMPARATIVE STUDY. PAFMJ, 71(1), 347-50. https://doi.org/10.51253/pafmj.v71i1.3599
Section
Original Articles