Vezikovajinal fistülün transvajinal ve abdominal teknik ile onarımı: Pamukkale Üniversitesi Üroloji Kliniği sonuçları

Öz

Amaç: Vezikovajinal fistül (VVF), mesane ve vajina arasındaki bir trakttan idrar kaçırmaya sebep olan, yaşam kalitesini, sosyal hayatı ve hasta sağlığını olumsuz etkileyen patolojik bir durumdur. VVF onarımında tercih edilen yöntem hastanın, fistülün özelliklerine göre ve cerrahın deneyimine göre yapılmaktadır. Vajinal ve abdominal VVF onarımı tercihinde kesinleşmiş kılavuz bilgileri bulunmamaktadır. Bu çalışmada, kliniğimizde opere edilen VVF vakaları retrospektif olarak değerlendirilerek hasta özelliklerinin ve sonuçlarının literatür ile karşılaştırılarak yorumlanması amaçlanmaktadır. Gereç ve yöntem: Bu çalışmada kliniğimizde vajinal ve abdominal VVF onarımı yapılan 35 hastanın verileri retrospektif olarak değerlendirildi. Bulgular: Hastaların 12’sinde (%34,3) abdominal yöntem tercih edilirken 23 (%65,7) hastada transvajinal yöntem tercih edildi. Kliniğimizde uygulanan VVF cerrahisinin başarı oranı %88,6 olarak tespit edilmiştir. Vajinal onarımda %91,4, abdominal onarımda ise %83,4 olarak birbirine yakın başarı oranları görüldü. Transvajinal teknik tercih edilen 23 hastanın 2’sinde (%8,6) ve abdominal teknik tercih edilen 12 hastanın ise 2’sinde (%16,6) nüks izlendi. Sonuç: Vezikovajinal fistül cerrahisinde hastanın ve fistülün özellikleri tercih edilecek cerrahiye yön gösterse de özellikle cerrahın deneyimi büyük rol oynamaktadır. Vajinal ve abdominal VVF cerrahisi birbirine benzer ve yüksek başarı oranları ile uygulanmaktadır.

Anahtar Kelimeler

• Vezikovajinal fistül
• vajinal vezikovajinal fistül onarımı
• abdominal vezikovajinal fistül onarımı

Repair of vesicovaginal fistula with transvaginal and abdominal technique: Pamukkale University Urology Clinic results

Abstract

Purpose: Vesicovaginal fistula (VVF) is a pathological condition that causes urinary incontinence from a tract between the bladder and the vagina, negatively affecting the quality of life, social life, and patient health. The preferred method for VVF repair depends on the patient's characteristics, the features of the fistula, and the surgeon's experience. There is no definitive guideline for choosing between vaginal and abdominal VVF repair. This study aims to retrospectively evaluate VVF cases operated on in our clinic, comparing and interpreting patient characteristics and outcomes with the literature. Materials and methods: The data of 35 patients who underwent vaginal and abdominal VVF repair in our clinic were evaluated retrospectively. Results: Transvaginal repair was preferred in 23 (65.7%) of the patients and abdominal repair was preferred in 12 (34.3%). The success rate of VVF surgery performed in our clinic was determined to be 88.6%. Success rates were similar; 91.4% in vaginal repair and 83.4% in abdominal repair. Recurrence was observed in 2 of 23 patients (8.6%) who underwent transvaginal repair and in 2 of 12 patients (16.6%) who underwent abdominal repair. Conclusion: In vesicovaginal fistula surgery, patient characteristics and fistula characteristics guide the preferred surgery. However, the surgeon's experience also plays a big role. Vaginal and abdominal VVF surgeries are performed with similar high success rates.

Keywords

• Vesicovaginal fistula
• vaginal vesicovaginal fistula repair
• abdominal vesicovaginal fistula repair

Kaynakça

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