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THE O'CONOR TECHNIQUE: THE GOLD STANDARD FOR SUPRATRIGONAL VESICOVAGINAL FISTULA REPAIR

1999; Lippincott Williams & Wilkins; Volume: 161; Issue: 2 Linguagem: Inglês

10.1016/s0022-5347(01)61951-7

1527-3792

Luciano Nesrallah, Miguel Srougi, Ruben F. Gittes,

Urological Disorders and Treatments

No AccessJournal of UrologyClinical Urology: Female Urology1 Feb 1999THE O'CONOR TECHNIQUE: THE GOLD STANDARD FOR SUPRATRIGONAL VESICOVAGINAL FISTULA REPAIR LUCIANO J. NESRALLAH, MIGUEL SROUGI, and RUBEN F. GITTES LUCIANO J. NESRALLAHLUCIANO J. NESRALLAH , MIGUEL SROUGIMIGUEL SROUGI , and RUBEN F. GITTESRUBEN F. GITTES View All Author Informationhttps://doi.org/10.1016/S0022-5347(01)61951-7AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: Several techniques have been used for repair of vesicovaginal fistula. Although surgical success is achieved in the majority of cases, a 4 to 35% failure rate occurs when a transvesical or transvaginal approach is used. We investigated the clinical efficacy of the O'Conor transperitoneal supravesical technique for supratrigonal vesicovaginal fistula. Materials and Methods: A total of 29 patients with iatrogenic supratrigonal vesicovaginal fistula following hysterectomy or cesarean section were studied. An initial operation and prior attempts at fistula repair had been performed in 9 patients (34%) for benign (26) or malignant (3) uterine conditions. All patients were treated with the O'Conor technique 6 weeks to 48 months (median 8 weeks) after fistula diagnosis. Results: The vesicovaginal fistula was successfully corrected in all patients at the first attempt and only 1 had stress urinary incontinence associated with urethral incompetence. No significant bladder dysfunction or decrease in bladder capacity was seen after repair. Conclusions: Considering the inferior clinical results of the transvaginal and transvesical approaches compared to the O'Conor technique for repair of supratrigonal vesicovaginal fistula, it would be unethical to conduct a randomized study to prove the superiority of the latter method. We suggest that the O'Conor technique be considered the gold standard surgical method of repair of supratrigonal vesicovaginal fistulas. References 1 : Urinary fistulas in the female. In: . Philadelphia: W. B. Saunders Co.1986: 2718. chapt. 74. Google Scholar 2 : Vesicovaginal fistula from the standpoint of the urologist. J. Urol.1951; 66: 579. Link, Google Scholar 3 : Nueva tecnica para el tratamiento de las fistulas vesicovaginales por via vaginal. Rev. Esp. Obst. Ginec.1948; 7: 45. Google Scholar 4 : The repair of vesicovaginal fistulas with interposition pedicle graft of labial tissue. Zentralbl. Gyneac.1928; 52: 480. Google Scholar 5 : New surgical approach for treatment of complex vesicovaginal fistula. J. Urol.1989; 141: 513. Link, Google Scholar 6 : Vesicovaginal and ureterovaginal fistulas: a summary of 25 years of experience. J. Urol.1980; 123: 370. Link, Google Scholar 7 : Vesicovaginal fistula on one urological service. J. Urol.1979; 121: 25. Abstract, Google Scholar 8 : Suprapubic closure of vesicovaginal fistula. J. Urol.1973; 109: 51. Link, Google Scholar 9 : Vesicovaginal fistula.. In: Urologic Surgery. Edited by . Philadelphia: J. B. Lippincott Co.1991: 479. chapt. 44. Google Scholar 10 : The post-total hysterectomy vesicovaginal fistula. J. Urol.1980; 123: 839. Abstract, Google Scholar 11 : Transvesical and transvaginal reparation in urinary vaginal fistulas. Int. J. Urol. Nephrol.1993; 25: 439. Google Scholar 12 : Vesicovaginal fistulas: the transperitoneal repair revisited. Scand. J. Urol. Nephrol.1994; 157: 101. Google Scholar 13 : Early versus late repair of vesicovaginal fistulas: vaginal and abdominal approaches. J. Urol.1995; 153: 1110. Link, Google Scholar 14 : Transvaginal repair of vesicovaginal fistula using a peritoneal flap. J. Urol.1993; 150: 56. Link, Google Scholar 15 : Treatment of vesicovaginal fistula by bladder mucosa autograft technique. J. Amer. Coll. Surg.1998; 186: 645. Google Scholar 16 : Results of treatment in 182 consecutive patients with genital fistulas. Int. J. Gynaec. Obst.1995; 48: 43. Google Scholar 17 : Repair of vesicovaginal fistula by a suprapubic transvesical approach. Surg., Gynec. & Obst.1980; 150: 57. Google Scholar 18 : Review of experience with vesicovaginal fistula repair. J. Urol.1980; 123: 367. Link, Google Scholar 19 : Early repair of iatrogenic injury to the ureter and bladder after gynecological surgery. J. Urol.1991; 146: 761. Link, Google Scholar 20 : Omental flap in transperitoneal repair of recurring vesicovaginal fistulas. Surg., Gynec. & Obst.1937; 64: 74. Google Scholar 21 : The use of the omental pedicle graft in urinary tract reconstruction. J. Urol.1976; 116: 341. Link, Google Scholar From the Division of Urology, Federal University of Sao Paulo, Sao Paulo, Brazil(NESRALLAH) Requests for reprints: Rua Peixoto Gomide, 515-7 andar, Sao Paulo, Brazil SP 01409-001.© 1999 by American Urological Association, Inc.FiguresReferencesRelatedDetailsCited byLee D, Dillon B, Lemack G and Zimmern P (2018) Long-Term Functional Outcomes Following Nonradiated Vesicovaginal RepairJournal of Urology, VOL. 191, NO. 1, (120-124), Online publication date: 1-Jan-2014.Ezzat M, Ezzat M, Tran V and Aboseif S (2018) Repair of Giant Vesicovaginal FistulasJournal of Urology, VOL. 181, NO. 3, (1184-1188), Online publication date: 1-Mar-2009.TABAKOV I and SLAVCHEV B (2018) Large Post-Hysterectomy and Post-Radiation Vesicovaginal Fistulas:: Repair by IleocystoplastyJournal of Urology, VOL. 171, NO. 1, (272-274), Online publication date: 1-Jan-2004.DALELA D, GOEL A, SHAKHWAR S and SINGH K (2018) Vesical Calculi With Unrepaired Vesicovaginal Fistula: A Clinical Appraisal of an Uncommon AssociationJournal of Urology, VOL. 170, NO. 6, (2206-2208), Online publication date: 1-Dec-2003. Volume 161Issue 2February 1999Page: 566-568 Advertisement Copyright & Permissions© 1999 by American Urological Association, Inc.MetricsAuthor Information LUCIANO J. NESRALLAH More articles by this author MIGUEL SROUGI More articles by this author RUBEN F. GITTES More articles by this author Expand All Advertisement PDF downloadLoading ...