Post abdominal hysterectomy vesico-vaginal fistula repair by oconnor technique

Abstract

Despite a long clinical history and extensive surgical experience, VVF continues to challenge even the most experienced gynecologic surgeon. The key is prevention with good surgical technique and identification and repair of the bladder injury at the time of index surgery. Patients with characteristics symptoms following an antecedent event should be treated with high clinical suspicion. Physical exam, laboratory evaluation, and ancillary testing should make the correct diagnosis in virtually all patients. If small and treated immediately after the antecedent event, conservative therapy with prolonged bladder drainage may be effective. However, most patients will require surgery, which can usually be performed successfully through a vaginal route. Abdominal procedures are reserved for more complicated cases. Adherence to strict surgical principles for fistula repair will result in optimal cure rates with minimal complications. Using these guidelines, both the clinician and patient should feel comfortable with the successful management of VVF. The incidence of genital fistulas can be reduced by vigilant care and meticulous surgery. Here we are discussing a case of post hysterectomy VVF in a 32 year old female who persisted to have urinary incontinence even after repeated attempts of repair by vaginal route.