Evaluation of quality of life, voiding, and sexual dysfunction following urogynecological fistula repair

Background: The urinary tract is at risk of injury during pelvic operations and complicated labor. Such injuries may lead to urogynecological fistula (UGF) whereby the urine bypasses the continence mechanisms and involuntarily leaks through genital tract. UGFs significantly impact quality of life, voiding function, and sexual health. This study evaluates outcomes following fistula repair surgery. Aims and Objectives: Assessing quality of life, voiding, and sexual dysfunction following urogenital fistula repair and Comparison of the parameters pre- and postoperative period. Secondary objective was identifying the prevalence of vesicovaginal fistula (VVF) in a tertiary care center. Materials and Methods: A cross-sectional study was conducted over 18 months at R. G. Kar Medical College and Hospital, including 50 patients with urogenital fistulas. Quality of life was measured using 36-item short-form health survey, voiding patterns using Incontinence Questionnaire-Urinary Incontinence Short Form, and sexual function using female sexual function index, assessed preoperatively and 6 months postoperatively. Results: In our study, the most commonly performed procedure was open transabdominal repair 23 (46.0%), followed by laparoscopic VVF repair 13 (26.0%) and ureteric reimplantation 11 (22.0%). Transvaginal approaches were less frequent, with only 2 (4.0%) undergoing transvaginal repair and 1 (2.0%) open transvaginal repair, indicating a preference for abdominal surgical techniques in managing these cases. The value of z is 5.1512 and P<0.00001. The result is considered significant at P<0.05. Conclusion: Urogynecological fistula repair greatly enhances quality of life by restoring urinary continence and improving social and emotional well-being. While voiding and sexual functions often improve, some patients may experience persistent dysfunctions. Ongoing follow-up and holistic care are essential to address these issues and ensure optimal long-term recovery and reintegration.