Within Our Walls: A Comprehensive Case Series on Vesicovaginal Fistula

Background: Vesicovaginal Fistula (VVF) may result from obstetric injuries or gynecologic surgeries, resulting in incontinence of urine, which needs surgical intervention to achieve the best results. Objectives: To evaluate the clinical presentation, surgical results, and complications in patients diagnosed and treated for Vesicovaginal Fistula. Methods: This was a descriptive, retrospective, single-center case series that evaluated 15 consecutive VVF patients treated at the Pakistan Kidney and Liver Institute & Research Center (PKLI&RC) in the time frame from September 2018 to September 2024 through transabdominal repair, depending on the size and site of the fistula. The data was collected pre-operatively, intra-operatively, and post-operatively. Results: The mean age was 43.00 ± 7.51 years with a mean BMI of 28.36 ± 5.16 kg/m2. A total of 12 patients (80%) complained of urine leakage via the vagina. Eight patients (53.3%) had previous VVF repair, with abdominal hysterectomy being the main cause in 4 patients (26.7%). The median operating time was 215 minutes (IQR 180-270 minutes) with a median post-operative stay of 5 days (IQR 4-6 days). Blood transfusion was not required. The complications seen were transient fever and discomfort in 2 patients (13.3%) with long-term complications in 2 patients (13.3%). Conclusion: Main causes of VVF include obstetric and gynecologic surgeries. Repair procedure, surgical method, results are good, and the complications are minimal. There are specific strategies that ought to be followed after the procedure to facilitate a successful recovery and to prevent a relapse.