REPAIR OF VESICOVAGINAL FISTULA BY A SUPRAPUBIC TRANSVESICAL APPROACH

  • 1 January 1980
    • journal article
    • research article
    • Vol. 150  (1) , 57-60
Abstract
Vesicovaginal fistulas [34] of various causes were repaired using a suprapubic, transvesical approach modified after the original technique of O''Conor. Only 4 failures resulted. Two of the failures were attributed to residual or recurrent carcinoma and 2 to poor tissue healing resulting from an inadequate delay between the initial surgical procedure and an attempt at reconstructive surgery. Surgical complications included 3 wound infections and one instance of severe gastrointestinal bleeding. Technical considerations thought to be important include excision of all diseased tissue in the bladder and vagina; complete separation of the bladder from the vagina with a margin of healthy tissue in all directions; careful, watertight closure of both bladder and vagina without tension; interposition of peritoneum or omentum between the closed bladder and vagina and initial postoperative maintenance of an uninfected and dry suture line.

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