Transection Type, Vesico-Vaginal Fistula Surgery

The objective of the study was to report the results of the surgery of the Vesico-vaginal fistula (VVF) transection types at CHU Conakry. Methods: This was a prospective descriptive study that focused on 64 patients operated for VVF transection type at the Urology department of CHU Conakry between January 2013 and December 2015. Four types of transection were defined according to the state of the urethra and vagina, the size of the fistula, the peri-fistulous tissue and associated lesions. The variables studied were the proportion of transection, age, the type of transection, the number of previous cures, the operative technique, the complications and the results after a follow-up of 3 months. Results: Transection accounted for 47.05% of the obstetric fistulas. The average age was 25.18 years old (14-43 years old). This was a Type I transection (11 cases), type II (27 cases), type III (19 cases) and type IV (7 cases). The surgical approach was vaginal in 64 cases. Fistulorraphy with a confection of a new cervix and cervico-urethral anastomosis was conducted in 19 patients, combined with bladder flap urethroplasty (30 patients) or vaginal flap (15 others). We recorded healing in 37 cases. Conclusion: Transection type VVF is a severe VVF. The preferential surgical approach was vaginal. Technical difficulties were related to associate lesions and the continence system affected.