SURGICAL TREATMENT OF URINARY AND FECAL INCONTIENANCE.

Abstract

ABSTRACT
INTRODUCTION: In underdeveloped nations, urinary and faecal incontinence is still a major
source of morbidity in gynaecological patients. Vesicovaginal fistula (VVF) is the most common
cause of urine incontinence, whereas rectovaginal (RVF) fistula, 3rd and 4th degree perineal
tears are the most common causes of faecal incontinence. In female urology, VVF is a serious
morbidity. Wetness, stench, and discomfort on a regular basis can lead to major social issues.
VVF, RVF, 3rd degree, and 4th degree perineal surgical therapy is dependent on correct
diagnosis and prompt repair using fundamental surgical concepts. The surgeon's training,
expertise, and accessible resources all influence the management procedures. The most common
surgical consequences include a failed operation and a recurrence of the fistula. The transvaginal
method is favoured for VVF because it has less problems. For greater availability of knowledge
and resources, repair procedures should be undertaken in tertiary care centres. METHODS: The
Women and Children Hospital in Abbottabad did this retrospective investigation. It contained the
medical information of 44 individuals who were surgically treated between 2010 and 2018.
RESULTS: In 48.1 percent of patients, the cause of VVF was obstetrical, and in 48.1 percent of
cases, the cause was iatrogenic. The transvaginal method was employed in 85 percent of patients
for surgical treatment of primary VVF, whereas the transabdominal technique was used in 7.4%
of cases. In our study, the success percentage of VVF after a single surgical intervention was
97.7%, whereas the success rate of faecal incontinence was 100%. Obstetrical causes of faecal
incontinence, such as obstructed labour and perineal tears, were found in every patient.
CONCLUSION: While birth trauma remains a prominent cause of VVF/RVF in our region, the
rising number of pelvic and gynaecological operations also contributes to a significant amount of
VVF. Prevention is achievable if adequate health care and public knowledge are provided. With
the first operation, a successful repair is achievable.