Functional success of vaginal-cuff excision as a technique for transvaginal repair of vesicovaginal fistulae after hysterectomy
Objective To examine the surgical and functional success of complete vaginal-cuff excision for transvaginal repair of vesicovaginal fistulae. Material and Methods Thirty-four women with posthysterectomy vesicovaginal fistulae presented for repair. Surgical technique included vaginal-cuff scar excision and fistula tract removal with a multilayer closure. The last 14 patients completed questionnaires and underwent pelvic prolapse staging (POP-Q) pre- and postoperatively. Results Thirty-nine percent of the women had previous attempts at closure of the fistula. Patients presented at an average of 24.6 weeks (range, 4-52 weeks) after the initial injury or a previous attempt. All patients were permanently dry. Fistula repair did not compromise ability to have sexual activity nor affect comfort during intercourse, and total vaginal length did not change. Nine percent of the women (3/34) had minor urinary urgency symptoms. Conclusion Transvaginal vaginal-cuff excision is an effective technique to repair posthysterectomy-induced fistulae. It preserves vaginal function and is not associated with urinary complications. © 2001 Lippincott Williams & Wilkins, Inc.
