Success Rate of Urogenital Fistula Repair and Predictors of Success: An Audit of Ten Years Data

Abstract

Aim: To evaluate the association of various predictive factors with the outcome of surgical repair of vesicovaginal fi stula.

Methods: The retrospective analysis was conducted at Maternal and Child Health, Pakistan Institute of Medical Sciences, Islamabad, and it comprised data related to patients having undergone vesicovaginal fi stula repair from January 2008 to June 2018. Statistical analysis of the record was done using SPSS 21 software.

Results: A total of 364 patients of urogenital fi stula repair were reviewed, with an overall success in 318 (87.4%) cases. There were no signifi cant differences in fi stula duration (p0.4), size of fi stula (p 0.34) and accessibility (p0.5) between successful and unsuccessful group. However, we found the association between the type of fi stula and history of previous repair attempts with the success of fi stula repair. Primary surgical repair of vesicovaginal (90.0%), vesicouterine (86%), ureteric (100%) and ureterovaginal (98%) were more successful as compared to repair with the history of 1 previous attempt (90.3%, 83.3%, 66.6% and 75% respectively). Success rate was found to further decrease with the history of more than one repair attempt of vesicovaginal (71.4%) and vesicouterine (66.5%) fi stula. Further, successful fi stula repair in women was also found to be signifi cantly associated with parity less than 4 (p 0.038).

Conclusions: Despite the higher success rate of urogenital fi stula repair, it’s important to refer the urogenital fi stula patients timely to specialized fi stula centres in order to achieve best results.

Keywords: fi stula, predictors, success, urogenital fi stula.