Department of Obstetrics and Gynecology, Amsterdam UMC location University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands. l.p.maljaars@amsterdamumc.nl.
Amsterdam Reproduction and Development research institute, Amsterdam, The Netherlands. l.p.maljaars@amsterdamumc.nl.
Department of Urology, UT Southwestern Medical Center at Dallas, 5323 Harry Hines Boulevard, JA5- 130 C, Dallas, TX 75390-9110, USA. Electronic address: Philippe.Zimmern@utsouthwestern.edu.
The objective of the study was to better understand the extent of the ischemic trauma and the effects of surgical repair on the vaginal microcirculation in patients with obstetric vesicovaginal fistul...
In this observational study, we evaluated the vaginal microvasculature surrounding VVF using handheld vital microscopy (HVM) before, during, and 2 weeks after surgical VVF repair....
Seventeen women undergoing VVF repair were included in this study....
The study was conducted in the Fistula Care Centre in Lilongwe, Malawi....
We used HVM with incident dark-field imaging to non-invasively visualize the microvasculature of the vaginal tissue surrounding fistulas. The primary outcome was the presence of microvascular flow. Se...
Microvascular flow was present before, during, and after surgical repair in, respectively, 83.8%, 83.9%, and 93.4% of obtained image sequences. The angioarchitecture was normal in 75.8% of the image s...
The study was limited by the lack of a control group and the relatively small sample size....
Although the vaginal microcirculation in women with VVF is compromised, extensive ischemic damage is not observed in the tissue surrounding fistulas. This suggests significant regenerative capacity of...
To assess and compile the current level of evidence regarding successful surgical treatment of vesicovaginal fistulae and how these perioperative interventions affect anatomic, patient-centered, and a...
PubMed and EMBASE were searched from inception through September 9, 2022....
This review included comparative studies (of any sample size) and single-group studies (1,000 or more participants) of primary or recurrent vesicovaginal fistula (ie, vesicovaginal fistula, urethrovag...
Forty-six studies met the inclusion criteria. Studies were categorized into 11 domains: 1) preoperative assessment, 2) preoperative and postoperative physical therapy, 3) route of surgery, 4) incorpor...
Our findings highlight the limited information available to guide evidence-based treatment of vesicovaginal fistula repair. Overall, high-quality evidence is lacking to provide guidelines; therefore, ...
PROSPERO, CRD42021214948....
Vesicovaginal fistula (VVF) is an uncommon cause of urinary incontinence (UI). Iatrogenic etiologies, especially abdominal hysterectomy, are most common; however, a minority of VVFs are caused by reta...
We present the case of a 53-year-old woman, gravida 0, with no prior pelvic surgery, with 2 months of intermittent UI and hematuria. Although initial diagnostic test results were negative, cystoscopy ...
This is a case of VVF secondary to a retained tampon fragment. In addition to this uncommon etiology, our patient's presenting symptoms were atypical, leading to a delay in diagnosis and treatment for...
There is a need for surgeons skilled in vesicovaginal fistula (VVF) repair, yet training opportunities are limited....
This study aimed to create a low-fidelity simulation model for transvaginal VVF repair, identify essential steps of VVF repair, and evaluate the model's ability to replicate essential steps....
First, a low-fidelity VVF repair simulation model was designed and built by the authors. Next, a hierarchical task analysis was performed by urogynecologic surgeons with expertise in VVF repair. Each ...
Five experts submitted an outline of steps for transvaginal VVF repair, and 4 experts participated in a focus group to reach consensus on the essential steps. Nine urogynecologic surgeons, with a medi...
We developed a novel, low-fidelity transvaginal VVF repair simulation model that consistently replicated tasks involving identification and closure of the fistula....
Vesicovaginal fistulas (VVF) are the most commonly acquired fistulas of the urinary tract. The management of VVF is mainly based on expert opinion and surgeon experience. This study aims to provide th...
This study utilizes the results of a survey among the surgeons who performs VVF repair in referral hospitals throughout Indonesia between June and July of 2021. Data analysis was carried out with SPSS...
We collected responses from 93 respondents consisting of 68 urologists and 25 gynecologists. The most commonly reported cause of VVF was obstetric (50.5%). Most respondents confirmed the diagnosis of ...
The transvaginal approach is preferred, either with or without an interposition tissue flap. The success rate at the first attempt is satisfactory....
This case highlights the need for further research to explore a potential link between systemic sclerosis and fistula development, and the importance of raising awareness among clinicians about this p...
The primary diagnosis in this case is systemic sclerosis (scleroderma) in a 47-year-old female patient with various clinical manifestations, including vesicovaginal and vesicorectal fistulas. The medi...
Pelvic fistulas affect a significant number of patients globally, with a relatively low prevalence in the United States. Virtual education offers an effective, scalable solution to bridge this educati...
We developed two virtual cases on rectovaginal and vesicovaginal/ureterovaginal fistulas to enhance medical students' exposure, knowledge, and confidence regarding assessment of pelvic fistulas. The c...
Forty medical students, ranging from first to third year, participated in the urogynecology elective; 21 (53%) completed the survey. Ninety-one percent agreed or strongly agreed they were satisfied wi...
Offering virtual and interactive patient cases on e-learning platforms represents an innovative approach to increasing clinical exposure to urogynecologic disorders. By providing medical students with...
Obstetric fistula is a devastating childbirth injury primarily caused by prolonged, obstructed labour. It leaves women incontinent, severely stigmatised and isolated. Fistula repair surgery can restor...
Multicentre, retrospective, observational, descriptive study....
The study analysed deidentified data from 24 568 surgical repairs supported by Fistula Foundation to treat women with obstetric fistula at 110 hospitals in 27 countries....
The data highlight patient characteristics and key trends and outcomes from obstetric fistula repair surgeries and related procedures. Of those surgeries, 87% resulted in a successful outcome (fistula...
This research provides essential insight from a vast, global network of hospitals providing highly effective fistula repair surgery. Further investment is needed to strengthen surgical capacity, incre...
Surgery for obstetric fistula is a highly effective treatment to restore continence and improve quality of life. However, a lack of data on the cost-effectiveness of this procedure limits prioritizati...
In 2021 and 2022, the Fistula Foundation funded 20 179 fistula surgeries and related procedures at 143 hospitals among 27 countries. We calculated DALYs averted specifically for vesicovaginal fistula ...
The total treatment cost was $7.6 million, and a total of 131 433 DALYs were averted. Thus, the cost per DALY averted-the cost to restore 1 year of healthy life-was $58. For this analysis, we took a c...
The current study demonstrates that obstetric fistula surgery, along with having a significant positive impact on maternal health outcomes, is highly cost-effective in comparison with other interventi...
Endometriosis is a complex condition causing surgical challenges, sometimes leading to urogynecological complications, the diagnosis and treatment of which are not always obvious. We present a case of...
