Vol. 6, Issue 1, Part A (2024)

Vesicovaginal fistula (VVF) is a distressing condition requiring surgical repair. This quasi-experimental study compared outcomes of open transabdominal transvesical (Group A) versus laparoscopic (Group B) VVF repair performed in the Urology Department, Dhaka Medical College Hospital, from March 2022 to August 2023. Thirty-seven patients meeting the inclusion criteria (supratrigonal VVF, fistula size <3 cm) were enrolled through purposive sampling and non-randomly assigned to two groups. Patients with complex, malignant, or recurrent fistulas or significant comorbidities were excluded. Baseline characteristics, surgical outcomes (operative time, blood loss, drain tube duration, hospital stay), and postoperative complications were assessed. Data were analyzed using SPSS version 26.0 with statistical significance set at p < 0.05.
Group A (n=20) underwent open transabdominal transvesical repair, and Group B (n=17) underwent laparoscopic repair. Both groups were comparable in age, BMI, fistula size, and baseline characteristics. Operative time was 125.05±15.60 minutes in Group A and 131.88±13.96 minutes in Group B (p=0.1726). Blood loss was 123.88 ml in Group A versus 70.23 ml in Group B (p = 0.8657). Drain tube duration (5.50±1.40 vs. 2.12±1.45 days) and hospital stay (7.90±1.37 vs. 4.00±1.37 days) were significantly shorter in Group B (p < 0.0001). Postoperative urinary leakage was 10% in Group A and 5.89% in Group B (p = 0.44). Laparoscopic VVF repair demonstrates advantages over the open approach in terms of reduced drain tube duration and hospital stay, with comparable safety and efficacy. Further studies are recommended to validate these findings.