Sexual function after vaginal and abdominal fistula repair

Mohr, Stefan; Brandner, Sonja; Mueller, Michael; Dreher, Ekkehard F.; Kuhn, Annette (2014). Sexual function after vaginal and abdominal fistula repair. American journal of obstetrics and gynecology, 211(1), 74.e1-74.e6. Elsevier 10.1016/j.ajog.2014.02.011

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OBJECTIVE The purpose of this study was to compare clinical outcomes and sexual function between transvaginal and transabdominal repairs of vesicovaginal fistulae (VVF). STUDY DESIGN Participants (99 women with VVF at a tertiary referral center) were treated with urinary catheterization for 12 weeks and, if the procedure was unsuccessful, underwent repair either the transvaginal (Latzko) or transabdominal technique. Objective clinical parameters were analyzed; subjective outcomes were recorded prospectively at the 6-month follow-up examination with the use of the female sexual function index to evaluate sexual function and the visual analogue scale to measure general disturbance by the fistula. RESULTS After bladder drainage for 12 weeks, 8 patients had spontaneous fistula closure. Demographic variables were similar in the transvaginal (n = 60) and transabdominal (n = 31) repair groups. The transvaginal procedure showed significantly shorter operation times, less blood loss, and shorter hospital stay. Continence rates 6 months after surgery were 82% (transvaginal) and 90% (transabdominal). Sexual function in the 64 sexually active patients was significantly improved, and overall disturbance by the fistula was reduced with both operative techniques. Neither surgical intervention was superior to the other regarding any domain of sexual function or visual analog scale. CONCLUSION Fistula repair improves sexual function and quality of life with no difference attributable to surgical route. Given this and that operating time, blood loss and length of stay are less with the transvaginal approach, the transvaginal approach is preferred in VVF repair if fistula and patient characteristics are suitable.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Gynaecology, Paediatrics and Endocrinology (DFKE) > Clinic of Gynaecology

UniBE Contributor:

Mohr, Stefan; Brandner, Sonja; Mueller, Michael and Kuhn, Annette

Subjects:

600 Technology > 610 Medicine & health

ISSN:

0002-9378

Publisher:

Elsevier

Language:

English

Submitter:

Nathalie Ursula Becher

Date Deposited:

13 Oct 2014 09:33

Last Modified:

11 Nov 2015 09:24

Publisher DOI:

10.1016/j.ajog.2014.02.011

PubMed ID:

24530974

Uncontrolled Keywords:

Latzko sexual function transabdominal repair transvaginal repair vesicovaginal fistula

BORIS DOI:

10.7892/boris.48960

URI:

https://boris.unibe.ch/id/eprint/48960

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