Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Multicenter Study
. 2014 Jan-Feb;20(1):7-13.
doi: 10.1097/SPV.0000000000000041.

Management of vesicovaginal fistulae: a multicenter analysis from the Fellows' Pelvic Research Network

Susan H Oakley  1 , Heidi W Brown, Joy A Greer, Monica L Richardson, Amos Adelowo, Ladin Yurteri-Kaplan, Fiona M Lindo, Kristie A Greene, Cynthia S Fok, Nicole M Book, Cristina M Saiz, Leon N Plowright, Heidi S Harvie, Rachel N Pauls
Affiliations
Multicenter Study

Management of vesicovaginal fistulae: a multicenter analysis from the Fellows' Pelvic Research Network

Susan H Oakley et al. Female Pelvic Med Reconstr Surg. 2014 Jan-Feb.

Abstract

Objectives: Vesicovaginal fistulae (VVF) are the most commonly acquired fistulae of the urinary tract, but we lack a standardized algorithm for their management. The purpose of this multicenter study was to describe practice patterns and treatment outcomes of VVF in the United States.

Methods: This institutional review board-approved multicenter review included 12 academic centers. Cases were identified using International Classification of Diseases codes for VVF from July 2006 through June 2011. Data collected included demographics, VVF type (simple or complex), location and size, management, and postoperative outcomes. χ(2), Fisher exact, and Student t tests, and odds ratios were used to compare VVF management strategies and treatment outcomes.

Results: Two hundred twenty-six subjects were included. The mean age was 50 (14) years; mean body mass index was 29 (8) kg/m(2). Most were postmenopausal (53.0%), nonsmokers (59.5%), and white (71.4%). Benign gynecologic surgery was the cause for most VVF (76.2%). Most of VVF identified were simple (77.0%). Sixty (26.5%) VVF were initially managed conservatively with catheter drainage, of which 11.7% (7/60) resolved. Of the 166 VVF initially managed surgically, 77.5% resolved. In all, 219 subjects underwent surgical treatment and 83.1% of these were cured.

Conclusions: Most of VVF in this series was managed initially with surgery, with a 77.5% success rate. Of those treated conservatively, only 11.7% resolved. Surgery should be considered as the preferred approach to treat primary VVF.

PubMed Disclaimer

Conflict of interest statement

The authors have declared they have no conflicts of interest.

Figures

FIGURE 1
FIGURE 1
Flow chart of study participants.
See this image and copyright information in PMC

References

    1. Harris WJ. Early complications of abdominal and vaginal hysterectomy. Obstet Gynecol Surv. 1995;50:795–805. - PubMed
    1. Karram MM. Lower urinary tract fistulae. In: Karram MM, Walters MD, editors. Urogynecology and Reconstructive Pelvic Surgery. Philadelphia, Pa: Mosby Elsevier; 2007. pp. 445–460.
    1. Katz VL. Anatomic defects of the abdominal wall and pelvic floor. In: Katz VL, Lentz GM, Lobo RA, et al., editors. Comprehensive Gynecology. Philadelphia, Pa: Mosby Elsevier; 2007. pp. 501–536.
    1. Nygaard I, Barber MD, Burgio KL, et al. Prevalence of symptomatic pelvic floor disorders in US women. JAMA. 2008;300:1311–1316. - PMC - PubMed
    1. Wong MJ, Wong K, Rezvan A, et al. Urogenital fistula. Female Pelvic Med Reconstr Surg. 2012;18:71–78. - PubMed

Publication types