Background: Vesicovaginal fistula (VVF) is an abnormal communication between the bladder and vagina requiring prompt diagnosis and timely repair. The optimal surgical approach remains debated, with transvaginal repair conventionally preferred for its lower morbidity; however, transabdominal approaches are increasingly employed for complex cases. Materials and Methods: This retrospective case review was conducted at the Urology Department of KIMS Hospital, BBSR, from January 2022 to January 2024. Twelve VVF cases were analyzed: six laparoscopic, four transvaginal, and two open transabdominal repairs. Outcome parameters included operative duration, intraoperative blood loss, catheter indwelling time, hospital stay, and perioperative complications. Statistical analysis was performed using Mann–Whitney U -test ( P < 0.05 considered statistically significant). Results: No statistically significant differences were observed between transabdominal and transvaginal repairs in operative time (229 min vs. 171 min, P = 0.073), blood loss (55 mL vs. 36 mL, P = 0.154), catheter indwelling time (27 days vs. 25 days, P = 0.570), or hospital stay (7 days vs. 5 days, P = 0.683). Fistula location predominantly supratrigonal (58.3%) or associated with ureterovaginal fistula (16.6%) favored transabdominal approach. Postoperative complications are managed conservatively. Conclusions: Both transabdominal (open/laparoscopic) and transvaginal approaches yield comparable outcomes when appropriately selected based on fistula location, complexity, and accessibility. Logical application of either technique, tailored to patient and lesion characteristics, ensures excellent functional outcomes without statistically significant differences in morbidity.
Panda et al. (Wed,) studied this question.