A NEW APPROACH TO THE SURGICAL TREATMENT OF VESICOVAGINAL FISTULAS

Abstract

The article presents an analysis of surgical treatment of 221 patients with vesicovaginal fistula. The age of the patients was 17-57 years (average age - 32 years). The duration of the fistula varied from 2-3 months to 31 years. The etiological factor of fistula was: obstetric traumas in 45.5%, gynecological surgeries in 55.8%, household traumas in 0.2%, car traumas in 0.2%. In 123 patients, the fistula removal operation (fistuloplasty) was performed transvaginally, in 76 patients - transvesically, in 16 - transabdominally, and in 2 - combined (transvaginally-vesically) method. 17 patients had fistula recurrence. During fistuloplasty, according to the principle proposed by the author, 3-row stitches were applied, which the author applied as the edges of the fistula were dissected. According to the author, this method of suturing prevents wound dehiscence, thereby significantly reducing the risk of recurrence. The author refers these seams "strengthening". All operations were successful, recovery was observed in 100% of cases. The success of operations also depends on the use of modern suture material.