The O'Conor technique: the gold standard for supratrigonal vesicovaginal fistula repair

The O'Conor technique: the gold standard for supratrigonal vesicovaginal fistula repair

Autor Nesrallah, L. J. Google Scholar
Srougi, M. Google Scholar
Gittes, R. F. Google Scholar
Instituição Universidade Federal de São Paulo (UNIFESP)
Resumo 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.
Palavra-chave vesicovaginal fistula
bladder
surgery
Idioma Inglês
Data de publicação 1999-02-01
Publicado em Journal of Urology. Philadelphia: Lippincott Williams & Wilkins, v. 161, n. 2, p. 566-568, 1999.
ISSN 0022-5347 (Sherpa/Romeo, fator de impacto)
Publicador Lippincott Williams & Wilkins
Extensão 566-568
Fonte http://dx.doi.org/10.1016/S0022-5347(01)61951-7
Direito de acesso Acesso restrito
Tipo Artigo
Web of Science WOS:000078136900055
Endereço permanente http://repositorio.unifesp.br/handle/11600/26028

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