https://doi.org/10.4081/aiua.2024.12450

Surgeon’s point of view in vesico-vaginal fistula management

Vol. 96 No. 2 (2024)
Submitted: March 7, 2024
Accepted: April 6, 2024
Published: June 27, 2024
Vesicovaginal fistula, genitourinary fistula, fistula
Abstract Views: 970
PDF: 279
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Authors

Kadek Budi Santosa
busanbsa@gmail.com
https://orcid.org/0000-0001-5295-2319
Department of Urology, Faculty of Medicine, Universitas Udayana; Prof. Dr. I.G.N.G Ngoerah General Hospital, Denpasar, Indonesia.
Stacia Novia Marta
Prof. Dr. I.G.N.G Ngoerah General Hospital, Denpasar; Department of Surgery, Faculty of Medicine, Universitas Udayana, Indonesia.
Ronald Sugianto
Prof. Dr. I.G.N.G Ngoerah General Hospital, Denpasar; Department of Urology, Faculty of Medicine, Universitas Airlangga, Indonesia.
Fina Widia
Department of Urology, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo General Hospital, Jakarta, Indonesia.
Parsaoran Nababan
Department of Urology, Bhayangkara Anton Soedjarwo Hospital, Pontianak, Indonesia.
Harrina Erlianti Rahardjp
Department of Urology, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo General Hospital, Jakarta, Indonesia.

Objectives: Vesicovaginal fistulas (VVF) are the most commonly acquired fistulas of the urinary tract. The management of VVF is mainly based on expert opinion and surgeon experience. This study aims to provide the practice patterns and outcomes of vesicovaginal fistula (VVF) management in Indonesia.

Methods: This study utilizes the results of a survey among the surgeons who performs VVF repair in referral hospitals throughout Indonesia between June and July of 2021. Data analysis was carried out with SPSS descriptively by displaying the relative frequency of the answers to each question of the questionnaire form.

Results: We collected responses from 93 respondents consisting of 68 urologists and 25 gynecologists. The most commonly reported cause of VVF was obstetric (50.5%). Most respondents confirmed the diagnosis of VVF by cystoscopy (81.7%). Waiting time to repair VVF was generally 12 weeks (79.6%), while the transvaginal approach repair was more often performed (77.4%). An additional procedure, such as tissue interposition was performed in 50.5% of cases. Tissue interposition was mostly indicated in recurrent VVF (81%), with omentum being the most selected tissue interposition (71%). When indicated, the most selected method of transabdominal approach was open transvesical (54,84%). A laparoscopic approach was performed only in 7.5% of cases. Overall, the success rate for VVF repair in Indonesia was 70-100% at first attempt.

Conclusions: The transvaginal approach is preferred, either with or without an interposition tissue flap. The success rate at the first attempt is satisfactory.

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How to Cite

Santosa, K. B., Marta, S. N., Sugianto, R., Widia, F., Nababan, P., & Rahardjp, H. E. (2024). Surgeon’s point of view in vesico-vaginal fistula management. Archivio Italiano Di Urologia E Andrologia, 96(2). https://doi.org/10.4081/aiua.2024.12450
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