TRANSPERITONEAL APPROACH WITH INTERPOSITION OF OMENTUM FOR THE REPAIR OF SUPRATRIGONAL VESICO-VAGINAL FISTULAE
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Abstract
Objectives: To determine the technical benefits and success rate of transperitoneal approach with interposition of
omentum for the repair of supratrigonal Vesico-vaginal fistulae (VVF).
Material and Methods: This study was carried out on 32 patients that were referred to our department from different
gynae units and maternity homes of NWFP. Thirty-one patients had primary and one patient had recurrent VVF. The
fistulae were approached transperitoneally, then Urinary bladder was opened between two stay sutures and closed
by a single layered continous extramucosal suturing technique, the vagina was closed continuously with the suture
passing through all layers. All the details of the patients were entered into a structured proforma.
Results: Mean fistula size was 2.8 cm (range 1.0 to 3.7 cm). Mean operation time was 120 minutes and only one
patient required a blood transfusion, and one patient required ureteroneocystomy. All except 2 patients who had a
recurrence, were dry after 2-3 weeks. One patient had wound infection and another has had frequency of micturition.
No patient suffered from peritonitis or adhesive intestinal obstruction.
Conclusion: The transperitoneal approach is safe, effective and gives good access to the bladder and ureter as well
as excellent functional results.
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