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KMID : 0358319820230050665
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Korean Journal of Urology
1982 Volume.23 No. 5 p.665 ~ p.669
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Clinical Observation on the Management of Vesicovaginal Fistulas
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김법완/Kim BW
이성준/Lee SC
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Abstract
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A clinical observation on the vesicovaginal repair was done on24 cases admitted to the Dep. of Urology, Keimyung University Hospital, during the period from 1971 through 1981.
Vesicovaginal fistula can be surgically repaired via vaginal route or transvesical extraperitoneal or transperitoneal technique and the following results were obtained.
1. Overall success rate of vesicovaginal fistula repair was 71% and that of simplified transperitoneal transvesical approach was higher than conventional method (88%).
2. Excision of the fistulas were facilitated by continuing traction on the Foley catheter, vaginal insertion of assistant`s finger and sand bag application below hip.
3. Preoperative infection with scar tissue, short duration, large sized fistula, inadequate exposure and dissection of bladder from vagina turned out to be main factors of the operative failure.
4. Wide exposure with tension free closure of well-vascularized peritoneal flaps and the judicious interposition of pedicled omentum have produced the most encouraging results and supravesical diversion by ileal or colonic conduit can be avoided.
5. Previous attempts for surgical repair seemed to have relation with success rate.
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