Khan Raza M, Raza Nabeela, Jehanzaib Mohammed, Sultana Ruqia
Department of Urology, Ayub Medical College & Teaching Hospital, Abbottabad.
J Ayub Med Coll Abbottabad. 2005 Jul-Sep;17(3):48-50.
Vesicovaginal fistula (VVF) is a disease that is rare in developed world but is frequently seen in poorer countries. It is mostly a result of gynaecological or obstetrical procedures. This study reports our experience of VVF.
This study was carried out at department of Urology, Ayub Teaching Hospital, Abbottabad from June 1998 to June 2004. Detailed history was taken to record age, nature of trauma, time interval of appearance of fistula and previous attempts of repair if any. In addition the results of repair were evaluated.
During this six years study period a total of 30 cases of urinary incontinence due to VVF were referred from Gynaecology and Obstetrics department for management, many gave history of birth trauma resulting in leakage of urine per vaginum. Majority of patients with VVF were between 21-40 years of age. All the patients presented with total incontinence of urine. Most common etiological factor was obstructed labour (63.33%). The other factors were caesarian section (13.33%), hysterectomy (13.33%), forceps delivery (3.33%) and bladder calculus (3.33%). A single case was due to carcinoma cervix and post irradiation (3.33%). Three out of 30 patients had one or more previous fistula repair attempts, while in the rest repair was not attempted before. We carried out transvesical repair in all patients, 80% of patients were completely cured and symptom free, 10% had stress incontinence with frequency of micturition but no vaginal leakage. Failure was 10%.
VVF is frequently encountered in Hazara division of Pakistan. It is mostly due to obstetrical causes.
膀胱阴道瘘（VVF）在发达国家是一种罕见疾病，但在较贫穷国家却经常见到。它主要是妇科或产科手术的结果。本研究报告了我们治疗膀胱阴道瘘的经验。
本研究于1998年6月至2004年6月在阿伯塔巴德阿尤布教学医院泌尿外科进行。详细记录病史以了解年龄、创伤性质、瘘管出现的时间间隔以及之前是否有修复尝试（如有）。此外，对修复结果进行了评估。
在这六年的研究期间，共有30例因膀胱阴道瘘导致的尿失禁患者从妇产科转诊来接受治疗，许多患者有分娩创伤史，导致尿液经阴道漏出。大多数膀胱阴道瘘患者年龄在21至40岁之间。所有患者均表现为完全性尿失禁。最常见的病因是产程梗阻（63.33%）。其他因素包括剖宫产（13.33%）、子宫切除术（13.33%）、产钳助产（3.33%）和膀胱结石（3.33%）。1例是由于宫颈癌及放疗后（3.33%）。30例患者中有3例曾有过一次或多次瘘管修复尝试，其余患者此前未尝试过修复。我们对所有患者进行了经膀胱修复，80%的患者完全治愈且无症状，10%有压力性尿失禁，尿频但无阴道漏尿。失败率为10%。
膀胱阴道瘘在巴基斯坦哈扎拉地区经常遇到。它主要是由产科原因引起的。
