Profile and repair success of vesico-vaginal fistula in Lahore.

OBJECTIVE: To describe the profile of patients with vesico-vaginal fistula (VVF) and success rate of the surgery. DESIGN: Descriptive study. PLACE AND DURATION OF STUDY: Sir Ganga Ram Hospital and Ghurki Trust Hospital, Lahore, between 1998 and 2002. patients and METHODS: All patients diagnosed as cases of vesico-vaginal fistula were included in the study. Those patients, who had previous unsuccessful surgery for vesico-vaginal repair, whether done in the hospital or outside, were also included. Their demographic profile and repair success was determined. RESULTS: Out of 2570 gynaecological admissions, 14 women had vesico-vaginal fistulae showing the prevalence of 0.55 / 100 gynaecological admissions. Obstetrical cause was found in 71.4% of the cases. The mean age of the patients was 34.85 +/- 6.3 years (range 25-45) with parity varying from 0-9 (median 4). The position of majority of the fistulas (57.2%) was high (vault, juxta-cervical). Success rate of the surgery in the study was 85.7%. Majority of the repairs (78.6%) were done through vaginal route. CONCLUSION: The most common cause of vesico-vaginal fistula in this study was obstetrical, either prolonged labour or caesarean hysterectomy. Although the success rate of repair was high, yet the attempt should be focussed on prevention.