Vesicovaginal fistulas in the developed world: An analysis of disease characteristics, treatments, and complications of surgical repair using the ACS-NSQIP database: Beyond the Abstract

Vesicovaginal fistulas (VVF) are a rare but devastating problem in the United States. They are usually caused by injury during surgery, most commonly hysterectomy. Most of the literature coming out of the United States on this topic consists of single center series from expert medical centers.

The goal of this study was to examine patient characteristics, complications, and surgical trends in vesicovaginal fistula repair from a more diverse set of surgeons and hospital settings using the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP).  This is also one of the only studies to contrast the abdominal and vaginal approaches to VVF repair. 

We found that most patients were relatively young and healthy.  The majority of repairs were performed by urologists, and some were performed by gynecologists. Over half of repairs were done through a vaginal (as opposed to abdominal) approach. For both approaches, the most common complication was urinary tract infection in 8% of patients. Compared to the vaginal approach abdominal VVF repairs had higher overall complications within 30 days and were more likely to be associated with sepsis, blood transfusion, and readmission to hospital.  However for both approaches the incidence of serious complications remains low. 

Written by: Doreen E. Chung

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