Transvaginal Repair of Vesicovaginal Fistula: "The standard of Care: Ten Years Experience

Abstract Background: Vesicovaginal fistula (VVF) is a debilitating condition leaving the effected female incontinent of urine. There has been a shift in the etiology of VVF in developing nations where hysterectomy is becoming a leading cause of VVF. Objective: To share our experience of transvaginal repair of VVF using a modified Latzko technique and evaluate various factors for a successful repair. Study type, settings and duration: This retrospective study was carried out at the Department of Urology and Kidney Transplantation, Fauji Foundation Hospital, Rawalpindi from March 2010, to August 2020. Methodology: Data were collected from patients who underwent transvaginal repair of VVF by a modified Latzko technique. Data consisting of multiple variables was analyzed using SPSS version 21. For qualitative data, percentages and frequencies were given and for quantitative data mean±SD were used. A comparison of two quantitative variables was done by using an independent t-test. For categorical variables, the chi-Square test was used. The p value ≤0.05 was taken as statistically significant. Results: A record of 144 patients was analyzed. Multivariate analysis revealed a statistically significant relationship between etiology (p-value 0.000), location (p-value 0.002) and size of VVF (p-value 0.000) and a successful repair, while number (p-value = 0.71) and VVF with a previous history of repair (p-value = 0.83) were insignificant factors. Success was observed in 98.6% while recurrence occurred in 1.4%. Conclusion: Transvaginal repair of Vesicovaginal fistula using a modified Latzko technique can be carried out in all vesicovaginal fistulae whether primary or recurrent irrespective of its aetiology, size, site and number. It has a high success rate and minimal complications.