Iatrogenic Vesicovaginal Fistula

Objective: To find the frequency of iatrogenic VVF in patients admitted for repair of VVF in Lady Willingdon Hospital, Lahore. Study Design: An observational study. Place and Duration of Study: Lady Willingdon Hospital, Lahore, from January 2007 to December 2008. Methodology: All cases of VVF treated at the centre during the study period were included in the study. The patients were admitted and evaluated through detailed history, physical examination, relevant investigations and evaluation under general anaesthesia (EUA). Iatrogenic VVF was defined as the one following gynaecological procedure. Repair was done through abdominal or vaginal route based on the findings of EUA. Results of repair were noted and analyzed using SPSS version 12. Results: Iatrogenic cases of VVF made more than half of the total cases (54%) while 46% were due to obstructed labour. Women under the age of 40 years, made up 77% of the total cases. The success rate for repair of VVF was 87%. Conclusion: This study shows that iatrogenic injuries in women under 40 years of age form a major share in the etiology of VVF requiring a check on the experience of surgeons doing the gynaecological and obstetrical surgeries in a developing country.