@article{Rizwan_Zia_Khurshid_Sajjad_Nawaz_Akmal_Kiani_2021, title={O’CONOR (TRANSABDOMINAL) REPAIR: IS IT ALWAYS NECESSARY TO INTERPOSE A FLAP IN SIMPLE VESICO-VAGINAL FISTULA? A COMPARATIVE STUDY}, volume={71}, url={https://pafmj.org/PAFMJ/article/view/3599}, DOI={10.51253/pafmj.v71i1.3599}, abstractNote={<p><strong>Objective:</strong> To assess morbidity and success of transabdominal (O’Conor) repair of vesicovaginal fistula with or<br>without interposition of flap between vagina and urinary bladder.</p> <p><strong>Study Design:</strong> Prospective comparative study.</p> <p><strong>Place and Duration of Study:</strong> Armed Forces Institute of Urology, Rawalpindi, from Mar 2016 to Jan 2019.</p> <p><strong>Methodology:</strong> Fifty five patients were randomized into group A & B by lottery method. An inclusion criterion<br>was single fistulous opening of ≤3cm. Complex and recurrent fistulae were excluded. Patients in group A underwent O’Conor repair without interpositional flap while in group B vesicovaginal fistulae were repaired with flap interposition.</p> <p><strong>Results:</strong> Twenty two patients were randomized in group A while 27 in group B. Mean age of patients was 41.65<br>± 11.93 years. Gynecological and obstetrical surgery was the main cause of fistula. Mean duration of surgery<br>was 162.7 ± 18.49 minutes. Per-operative ureteric catheterization was done in 9 (16.8%) patients. Seventeen<br>(30.6%) patients had paralytic ileus. There was transient fever in 4 (7.6%) of cases and wound infection was seen<br>in 3 (5.8%) of patients. Mean hospital stay was 3.4 ± 2.3 days. Cystogram was done in 35 (64.5%) of patients before the removal of per-urethral catheter. The overall success rate was 92.9%. Ten (18.2%) of patients developed denovo urgency which was managed conservatively. There was no statistical difference in both groups in terms of morbidity and success.</p> <p><strong>Conclusion:</strong> In simple Vesico-vaginal fistulae repair, interposition of flap can be omitted and it does not affect the outcomes in terms of success and morbidity.</p>}, number={1}, journal={Pakistan Armed Forces Medical Journal}, author={Rizwan, Asma and Zia, Qamar and Khurshid, Adil and Sajjad, Mudassar and Nawaz, Muhammad and Akmal, Muhammad and Kiani, Faran}, year={2021}, month={Feb.}, pages={347–50} }