Ali Nawaz, Muhammad Iqbal Khan, Riffat Arbab, Masha Khan, Shabir Ahmed Lehri, Hafsa Jaffar.
Surgical management of Vesicovaginal fistula at Postgraduate Medical Institute, Sandman Provincial Hospital, Quetta.
Pak J Surg Jan ;37(4):265-72.

Introduction: Vesicovaginal Fistula (VVF), a term that has major impact over female urology considering morbidity rate. It is still considered as an unresolved issue for many developing countries. Some of the initial symptoms involve discomfort, continual wetness, and odor concerns that could arise serious complications. The early diagnosis and timely measures along with the application of surgical principles, and interposition flaps should need to be practiced. Research statistics states that around 3 million women residing in under-privileged countries have uncured Vesicovaginal Fistulas. The rational of this study is to find out causes of Vesicovaginal Fistula and which treatment is batter for which level and size of Fistula. Objective: To evaluate the causes of Vesicovaginal Fistula and to study the type, size, level, site of Fistula and mode of treatment. Material and Methods: A descriptive cross-sectional research was conducted along with the practice of successive non-probability sampling approach. Study area selected was Department of Urology, Postgraduate Medical Institute (PGMI), Sandeman Provincial Hospital, Quetta. The study was conducted from 1st of January 2021 to 30th June2021. Results: Out of 126 patients general average age reported was 29.58+-6.55years while average age in diabetic and non-diabetic group was 29.61+-6.60 years and 29.55+-6.55 years respectively. Generally, the mean pulse rate 77.77+-1.48 beats/min, systolic blood pressure 106.11+-10.23 mmHg, diastolic blood pressure 68.67+-5.20 mmHg, temperature 98.55+-0.19 0 F, hemoglobin 12.16+-1.49 g/dL, total leucocyte count 7.53+-1.75/cmm, blood serum creatinine 0.85+-0.19 unit, fasting blood sugar 113.41+-22.72 mg/dL and hospital stay was 6.38+-1.95 days. The results showed significant association of study group with Vesicovaginal Fistula probable cause with p value 0.003. Conclusion: For treating the simple fistulas, transvaginal approach can be practiced regardless of the fistula position as it is an intrusive approach apart from ensuring treatment success. However, for curing complex fi stulas, transabdominal approach needs to be executed as it permits simultaneous adjustment of allied glitch.

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