Bladder stones in vesicovaginal fistula: is concurrent repair an option? Experience with 87 patients
Introduction and hypothesis The objective was to assess the outcomes of a one-stage approach to bladder stones in the setting of a vesicovaginal fistula, performing fistula repair concurrently with stone extraction. Methods Retrospective review of urogenital fistula surgeries at Evangel VVF Center i...
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| Veröffentlicht in: | International Urogynecology Journal 2017-04, Vol.28 (4), p.569-574 |
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| creator | Shephard, Steven N. Lengmang, Sunday J. Kirschner, Carolyn V. |
| description | Introduction and hypothesis
The objective was to assess the outcomes of a one-stage approach to bladder stones in the setting of a vesicovaginal fistula, performing fistula repair concurrently with stone extraction.
Methods
Retrospective review of urogenital fistula surgeries at Evangel VVF Center in Jos, Nigeria, between December 2003 and April 2014, identified 87 women with bladder stones accompanying their fistulas and 2,979 repaired without stones. Concurrent stone extraction and fistula repair were performed in 51 patients. Outcomes were compared with respect to fistula size, classification, and fibrosis.
Results
Women presenting with bladder stones were older and had larger fistulas than those without stones (
P
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| doi_str_mv | 10.1007/s00192-016-3142-1 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1859730164</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1859730164</sourcerecordid><originalsourceid>FETCH-LOGICAL-c372t-42d4947566273855859ddd2888b7ded4b50313f0265353b2f1bc7eaf0fbaa3353</originalsourceid><addsrcrecordid>eNp1kc9LHTEQx4NU9Gn7B3gpgV68bDv5tdnXS1HRtiB40XPIbmY1si9Zk6xt__vm8ayUQk-ByWc-w8yXkBMGHxmA_pQB2Jo3wNpGMMkbtkdWTArRCODiDVnBWuhGyJYfkqOcHwFAgoIDcsh1KwFasSLufLLOYaK5xICZ-kCfMfshPtt7H-xER5_LMtnP1Gc6xDAsKWEoNOFsfaI20DgXH8MXevlzxuQxDEh_-PJAO01nW2qh5Ldkf7RTxncv7zG5u7q8vfjWXN98_X5xdt0MQvPSSO7kWmrVtlyLTqlOrZ1zvOu6Xjt0slcgmBiBt0oo0fOR9YNGO8LYWytq6Zic7rxzik8L5mI2Pg84TTZgXLJh1ahFPZes6Id_0Me4pLrwlupYqzsldaXYjhpSzDnhaObkNzb9MgzMNgKzi8BUp9lGYFjtef9iXvoNuteOPzevAN8BuX6Fe0x_jf6v9Te6k5Aq</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1881678547</pqid></control><display><type>article</type><title>Bladder stones in vesicovaginal fistula: is concurrent repair an option? Experience with 87 patients</title><source>MEDLINE</source><source>SpringerNature Complete Journals</source><creator>Shephard, Steven N. ; Lengmang, Sunday J. ; Kirschner, Carolyn V.</creator><creatorcontrib>Shephard, Steven N. ; Lengmang, Sunday J. ; Kirschner, Carolyn V.</creatorcontrib><description>Introduction and hypothesis
The objective was to assess the outcomes of a one-stage approach to bladder stones in the setting of a vesicovaginal fistula, performing fistula repair concurrently with stone extraction.
Methods
Retrospective review of urogenital fistula surgeries at Evangel VVF Center in Jos, Nigeria, between December 2003 and April 2014, identified 87 women with bladder stones accompanying their fistulas and 2,979 repaired without stones. Concurrent stone extraction and fistula repair were performed in 51 patients. Outcomes were compared with respect to fistula size, classification, and fibrosis.
Results
Women presenting with bladder stones were older and had larger fistulas than those without stones (
P
< 0.001). Additionally, their fistulas were more often classifiable as large and less often as high (
P
= 0.02), and were more fibrotic (
P
= 0.003). Twenty-six (51 %) patients with concurrent repair successfully became dry. Comparing results by classification, concurrent repair of high fistulas with stones was very likely to be successful (OR 8.8, 95% CI 1.0–78.2), whereas low fistulas were not (OR 0.2, 95% CI 0.02–0.7). Outcomes were similar to those of patients without stones, except for low fistulas, which were 5 times more likely to fail (
P
= 0.04).
Conclusion
Concurrent closure of vesicovaginal fistula at the time of bladder stone extraction is possible and, in many respects, preferable to a staged approach, particularly among high or midvaginal fistulas.</description><identifier>ISSN: 0937-3462</identifier><identifier>EISSN: 1433-3023</identifier><identifier>DOI: 10.1007/s00192-016-3142-1</identifier><identifier>PMID: 27640063</identifier><language>eng</language><publisher>London: Springer London</publisher><subject>Adult ; Female ; Gynecology ; Humans ; Medicine ; Medicine & Public Health ; Middle Aged ; Original Article ; Retrospective Studies ; Treatment Outcome ; Urinary Bladder Calculi - complications ; Urinary Bladder Calculi - surgery ; Urologic Surgical Procedures ; Urology ; Vesicovaginal Fistula - complications ; Vesicovaginal Fistula - surgery ; Young Adult</subject><ispartof>International Urogynecology Journal, 2017-04, Vol.28 (4), p.569-574</ispartof><rights>The International Urogynecological Association 2016</rights><rights>International Urogynecology Journal is a copyright of Springer, 2017.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c372t-42d4947566273855859ddd2888b7ded4b50313f0265353b2f1bc7eaf0fbaa3353</citedby><cites>FETCH-LOGICAL-c372t-42d4947566273855859ddd2888b7ded4b50313f0265353b2f1bc7eaf0fbaa3353</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00192-016-3142-1$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00192-016-3142-1$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27903,27904,41467,42536,51297</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27640063$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Shephard, Steven N.</creatorcontrib><creatorcontrib>Lengmang, Sunday J.</creatorcontrib><creatorcontrib>Kirschner, Carolyn V.</creatorcontrib><title>Bladder stones in vesicovaginal fistula: is concurrent repair an option? Experience with 87 patients</title><title>International Urogynecology Journal</title><addtitle>Int Urogynecol J</addtitle><addtitle>Int Urogynecol J</addtitle><description>Introduction and hypothesis
The objective was to assess the outcomes of a one-stage approach to bladder stones in the setting of a vesicovaginal fistula, performing fistula repair concurrently with stone extraction.
Methods
Retrospective review of urogenital fistula surgeries at Evangel VVF Center in Jos, Nigeria, between December 2003 and April 2014, identified 87 women with bladder stones accompanying their fistulas and 2,979 repaired without stones. Concurrent stone extraction and fistula repair were performed in 51 patients. Outcomes were compared with respect to fistula size, classification, and fibrosis.
Results
Women presenting with bladder stones were older and had larger fistulas than those without stones (
P
< 0.001). Additionally, their fistulas were more often classifiable as large and less often as high (
P
= 0.02), and were more fibrotic (
P
= 0.003). Twenty-six (51 %) patients with concurrent repair successfully became dry. Comparing results by classification, concurrent repair of high fistulas with stones was very likely to be successful (OR 8.8, 95% CI 1.0–78.2), whereas low fistulas were not (OR 0.2, 95% CI 0.02–0.7). Outcomes were similar to those of patients without stones, except for low fistulas, which were 5 times more likely to fail (
P
= 0.04).
Conclusion
Concurrent closure of vesicovaginal fistula at the time of bladder stone extraction is possible and, in many respects, preferable to a staged approach, particularly among high or midvaginal fistulas.</description><subject>Adult</subject><subject>Female</subject><subject>Gynecology</subject><subject>Humans</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Original Article</subject><subject>Retrospective Studies</subject><subject>Treatment Outcome</subject><subject>Urinary Bladder Calculi - complications</subject><subject>Urinary Bladder Calculi - surgery</subject><subject>Urologic Surgical Procedures</subject><subject>Urology</subject><subject>Vesicovaginal Fistula - complications</subject><subject>Vesicovaginal Fistula - surgery</subject><subject>Young Adult</subject><issn>0937-3462</issn><issn>1433-3023</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNp1kc9LHTEQx4NU9Gn7B3gpgV68bDv5tdnXS1HRtiB40XPIbmY1si9Zk6xt__vm8ayUQk-ByWc-w8yXkBMGHxmA_pQB2Jo3wNpGMMkbtkdWTArRCODiDVnBWuhGyJYfkqOcHwFAgoIDcsh1KwFasSLufLLOYaK5xICZ-kCfMfshPtt7H-xER5_LMtnP1Gc6xDAsKWEoNOFsfaI20DgXH8MXevlzxuQxDEh_-PJAO01nW2qh5Ldkf7RTxncv7zG5u7q8vfjWXN98_X5xdt0MQvPSSO7kWmrVtlyLTqlOrZ1zvOu6Xjt0slcgmBiBt0oo0fOR9YNGO8LYWytq6Zic7rxzik8L5mI2Pg84TTZgXLJh1ahFPZes6Id_0Me4pLrwlupYqzsldaXYjhpSzDnhaObkNzb9MgzMNgKzi8BUp9lGYFjtef9iXvoNuteOPzevAN8BuX6Fe0x_jf6v9Te6k5Aq</recordid><startdate>20170401</startdate><enddate>20170401</enddate><creator>Shephard, Steven N.</creator><creator>Lengmang, Sunday J.</creator><creator>Kirschner, Carolyn V.</creator><general>Springer London</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope></search><sort><creationdate>20170401</creationdate><title>Bladder stones in vesicovaginal fistula: is concurrent repair an option? Experience with 87 patients</title><author>Shephard, Steven N. ; Lengmang, Sunday J. ; Kirschner, Carolyn V.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c372t-42d4947566273855859ddd2888b7ded4b50313f0265353b2f1bc7eaf0fbaa3353</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Adult</topic><topic>Female</topic><topic>Gynecology</topic><topic>Humans</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Original Article</topic><topic>Retrospective Studies</topic><topic>Treatment Outcome</topic><topic>Urinary Bladder Calculi - complications</topic><topic>Urinary Bladder Calculi - surgery</topic><topic>Urologic Surgical Procedures</topic><topic>Urology</topic><topic>Vesicovaginal Fistula - complications</topic><topic>Vesicovaginal Fistula - surgery</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Shephard, Steven N.</creatorcontrib><creatorcontrib>Lengmang, Sunday J.</creatorcontrib><creatorcontrib>Kirschner, Carolyn V.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><jtitle>International Urogynecology Journal</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Shephard, Steven N.</au><au>Lengmang, Sunday J.</au><au>Kirschner, Carolyn V.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Bladder stones in vesicovaginal fistula: is concurrent repair an option? Experience with 87 patients</atitle><jtitle>International Urogynecology Journal</jtitle><stitle>Int Urogynecol J</stitle><addtitle>Int Urogynecol J</addtitle><date>2017-04-01</date><risdate>2017</risdate><volume>28</volume><issue>4</issue><spage>569</spage><epage>574</epage><pages>569-574</pages><issn>0937-3462</issn><eissn>1433-3023</eissn><abstract>Introduction and hypothesis
The objective was to assess the outcomes of a one-stage approach to bladder stones in the setting of a vesicovaginal fistula, performing fistula repair concurrently with stone extraction.
Methods
Retrospective review of urogenital fistula surgeries at Evangel VVF Center in Jos, Nigeria, between December 2003 and April 2014, identified 87 women with bladder stones accompanying their fistulas and 2,979 repaired without stones. Concurrent stone extraction and fistula repair were performed in 51 patients. Outcomes were compared with respect to fistula size, classification, and fibrosis.
Results
Women presenting with bladder stones were older and had larger fistulas than those without stones (
P
< 0.001). Additionally, their fistulas were more often classifiable as large and less often as high (
P
= 0.02), and were more fibrotic (
P
= 0.003). Twenty-six (51 %) patients with concurrent repair successfully became dry. Comparing results by classification, concurrent repair of high fistulas with stones was very likely to be successful (OR 8.8, 95% CI 1.0–78.2), whereas low fistulas were not (OR 0.2, 95% CI 0.02–0.7). Outcomes were similar to those of patients without stones, except for low fistulas, which were 5 times more likely to fail (
P
= 0.04).
Conclusion
Concurrent closure of vesicovaginal fistula at the time of bladder stone extraction is possible and, in many respects, preferable to a staged approach, particularly among high or midvaginal fistulas.</abstract><cop>London</cop><pub>Springer London</pub><pmid>27640063</pmid><doi>10.1007/s00192-016-3142-1</doi><tpages>6</tpages></addata></record> |
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| subjects | Adult Female Gynecology Humans Medicine Medicine & Public Health Middle Aged Original Article Retrospective Studies Treatment Outcome Urinary Bladder Calculi - complications Urinary Bladder Calculi - surgery Urologic Surgical Procedures Urology Vesicovaginal Fistula - complications Vesicovaginal Fistula - surgery Young Adult |
| title | Bladder stones in vesicovaginal fistula: is concurrent repair an option? Experience with 87 patients |
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