Comparative Analysis of Outcome between Laparoscopic versus transabdominal Open Surgical Repair for Vesicovaginal Fistula

Abstract

Objectives: Vesicovaginal fistulas (VVF) have detrimental psychosomatic effects on women. Many publications exist on various approaches to VVF repair. Most of the surgeons are trained in open repair of VVF. Laparoscopic VVF repair is gaining popularity. The purpose of this study is to report our experience in the repair of vesicovaginal fistulas (VVF) by open and laparoscopic techniques and compare outcomes.

Material and methods: A retrospective study was conducted with the data of the patients who underwent VVF repair from 2017 to 2022. Out of the 60 VVF patients, 27 were managed laparoscopically (group 1) and 33 by open repair (group 2). Data on the etiology, size, number, location, mean operative time, need for blood transfusion, and postoperative complications were analyzed.

Results: The mean operative time (hours) in the laparoscopic group (group 1) was (5.01 ±1.06), and in the open group (group 2), it was (3.09 ± 1.03; p<0.01). The mean hospital stay (days) in group 1 was 6.67 ± 1.14, and in group 2, it was 9.30 ± 2.09 (p<0.001). Two patients needed blood transfusions in group 1 and three patients in group 2 (p<0.015). Postoperative complications were more commonly seen in the open-repair group (p<0.034). Recurrence of fistula was seen in two patients in group 1 and four patients in group 2 (p<0.545) in six-month postoperative follow-up data.

Conclusion: Laparoscopic VVF repair is a feasible option for primary as well as recurrent VVF. It is associated with less postoperative morbidity and complications.

Bangladesh J Obstet Gynaecol, 2024; Vol. 39(1): 24-29