In Support of Early Treatment of Postoperative Vesicovaginal Fistulas

In Brief Objective: The timing of surgery and the surgical approach of choice for vesicovaginal fistulas (VVFs) are matters of continuing debate. We review our experience with early treatment of postoperative VVFs. Methods: From 1988 to 2003, 26 patients aged 18 to 70 years (mean, 47.7 years) underwent early reconstructive surgery in our departments for VVFs that had all been caused by previous pelvic surgery. Results: The reconstructive surgery was carried out within the first 2 months (mean, 41 days; range, 5 days to 8 weeks) after the initial surgical procedure. The repair was accomplished by a transvaginal approach in 19 cases, by an extraperitoneal transvesical approach in 5, and by a combination of transvesical and transvaginal approaches in 2. Follow up was at least 1 year. The VVFs were successfully corrected in all 26 cases. Conclusions: VVFs resulting from pelvic surgery can be successfully managed by early repair, thus sparing the patient considerable distress and inconvenience. We review our experience with early treatment of 26 patients with postoperative VVFs, that had all been caused by previous pelvic surgery. The VVFs were successfully corrected in all 26 cases. VVFs resulting from pelvic surgery can be successfully managed by an early repair, thus sparing the patient considerable distress and inconvenience.