The role of omentum flap in success of vesicovaginal fistula repair

Abstract EN

Purpose : the higher recurrence rate of vesicovaginal fistulae, need new modalities of repair, we evaluate the use of omental flap interposition in preventing recurrence, in comparing the repair without flap.

Materials and Methods : A prospective study on 39 patients underwent vesicovaginal fistula repair in AL-Zahra teaching hospital from May 2005 until May 2010.

16 (41 %) were omental flap interposition used, 10(62 %) need pedicled "J" omentum flap and 6(38 %) with complete omentum flap.

while in 23 (59 %), repair done without flap.

All patients were treated from 3-6 months after fistula diagnosis.

Results: From 39 patients, 20(51 %) due to obstetrical causes, 6 (15 %) patients following prolonged obstructed labour, 8 (21 %) patients following emergency cesarean section, and 6 (15 %) patients following emergency hysterectomy, as a consequence of rupture gravid uterus, and 19 (49 %) following elective hysterectomy due to gynecological causes which includes, 3(8%) uterine fibroid, 15 (38 %) dysfunctional menstrual bleeding and 1(3 %) uterine prolapsed.

The mean age of patients 37 years (20-55years).

In 16(41 %) patients were omentum flap interposition used, all of them (100 %) were cured, While in 23(59 %) patients, repair done without flap, 4(17 %) of them are failed and 19(83 %) cured.

Two patients from 4 patients failed were diabetic and 2 patients underwent recurrent cesarean section (CS).

Conclusion: We conclude that omentum interposition have good result in preventing recurrence of vesicovaginal fistulae, which is simple and easily done.