Vol. 6, Issue 1, Part B (2024)

Background: Vesicovaginal fistula (VVF) represents an atypical connection that occurs between the urinary bladder as well as the vagina. It stands as the most prevalent urogenital fistula type. Among developing nations, VVF frequently occurs as a result of inadequate obstetric care. This work was aimed at evaluating the laparoscopic and open transabdominal surgical repair outcomes for high VVF (above the trigone).
Methods: The prospective randomized clinical study included 40 cases developing high VVF who were amenable for either technique of surgical correction: open trans-abdominal or laparoscopic. Cases underwent an equal allocation into two groups: Group A: Open trans-abdominal surgical repair group and group B: Laparoscopic group.
Results: Blood loss, hospital stays, patient recovery and wound infection showed significant higher values within group A in comparison to group B. The operative time, intraoperative complications, time to catheter removal, hemoglobin deficit, urinary tract infection, wound dehiscence, ileus, incontinence and dyspareunia showed insignificant variance among two groups. Visual analogue scale, the need for analgesics, as well as number of analgesic requirements showed a significant reduction within Group B in comparison to Group A (p<0.001). Physical functioning, role limitation as a result of physical health, emotional problem, vitality, emotional wellbeing, social functioning, general health, clinical outcome and success rate showed insignificant variance among both groups. Pain showed a significant reduction within group B in comparison to group A (P=0.032).
Conclusions: Laparoscopic technique has shown even better results and enjoyed less blood loss, less hospital stays, better convalescence, and acceptance by the patients.