IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) e-ISSN: 2279-0853, p-ISSN: 2279-0861.Volume 20, Issue 2 Ser.7 (February. 2021), PP 24-33 www.iosrjournals.org DOI: 10.9790/0853-2002072433 www.iosrjournal.org 24 | Page Outcome of Open Transvesical Repair of Vesicovaginal Fistulae in Comparison to Transperitonial Extravasical Repair Md. Azizur Rahman 1 , Rokhsana Sarmin 2 S. M. Mamun Mohar 3 , Abdullah Md Abu Ayub Ansary 4 , Md. Mizanur Rahman 5 1 Junior Consultant (Surgery), Dhaka Medical College Hospital, Dhaka, Bangladesh. 2 Junior Consultant (Surgery), 250 bedded Mohammad Ali Hospital, Bogura 3 Junior Consultant (Surgery), Dhaka Medical College Hospital, Dhaka, Bangladesh. 4 Junior Consultant (surgery),OSD, Directorate General of Health Services (DGHS), Dhaka, Bangladesh 5 Professor, Department of Urology, Dhaka Medical College Hospital, Dhaka, Bangladesh. Corresponding Author: Md. Azizur Rahman 1 Abstract: Background: Vesicovaginal fistulae (VVF) are the most common acquired fistula of the urinary tract and have been known since ancient times. The etiology of VVF differs in various parts of the world. In the industrialized world, the most common cause (>75%) of VVF is injury to the bladder at the time of gynecologic, urologic, or other pelvic surgery. In our country VVF most commonly occur as a result of prolonged obstructed labor due to cephalopelvic disproportion, with resulting pressure necrosis to the anterior vaginal wall, bladder, bladder neck, and proximal urethra from the baby and as a post-surgical (Total abdominal hysterectomy, vaginal hysterectomy, lower uterine cesarean section).The goal of treatment of VVF is the rapid cessation of urinary leakage with return of normal and complete urinary and genital function. Open trans vesical repair of vesico vaginal fistula is a safe and efficient method vesicovaginal fistula repair. Objectives: The primary purpose of this study is to find the outcome of open transvesical repair of vesicovaginal fistulae in comparison to transperitonial extravasical repair. Methods and Materials: This prospective type of observational study performed in the Department of Dhaka Medical College Hospital, Dhaka during the period from January 2018 to December 2018. This study was carried on patients who were diagnosed as Vesicovaginal Fistula on clinical examination and cystoscopic examination. Data collected in a pre-designed questionnaire by face to face interview. Data analyses completed by the help of SPSS version 16. Results: Total 32 consecutive patients selected purposefully. Every patient evaluated by clinical examination, appropriate investigations and after 12 weeks of the onset of VVF, then half of the patient were unergone transvasical and half of the patient undergone extravasical repair. Then the immediate and late post-operative outcome evaluated. The patient informed about the nature of the study. A written consent taken from the patient. Conclusion: Open transperitonial repair of vesico vaginal fistula is a safe and efficient method of supratrigonal vesico vaginal fistula repair. So the outcome of open transvesical repair of vesicovaginal fistulae is not better than transperitonial repair rather transperitonial repair is to some extent. Key Words: Vesicovaginal Fistulae (VVF); Transvesical repair, Extravasical repair, Comparative study. --------------------------------------------------------------------------------------------------------------------------------------- Date of Submission: 03-02-2021 Date of Acceptance: 18-02-2021 --------------------------------------------------------------------------------------------------------------------------------------- I. Introduction Vesicovaginal fistulae (VVF) is an abnormal communication between the bladder and vagina, which results in continuous involuntary loss of urine through the vagina. It is among the most distressing and socially devastating conditions among women, and occurs most commonly as a result of obstetrical and gynecological injury. 1 The overall incidence of VVF because of gynecological surgery is estimated to be 1 of every 1200 hysterectomies and 1 of every 455 laparoscopic hysterectomies. 2 The uncontrolled leakage of urine into the vagina is the hallmark symptom of patients with Urogenital Fistula. Increased post-operative abdominal, pelvic, or flank pain; prolonged ileus; and fever should alert the physician to possible urinoma or urine ascites and mandates expeditious evaluation. Recurrent cystitis or pyelonephritis, abnormal urinary stream, and hematuria also should initiate a workup for UGF. 3,4,5 The time from initial insult to clinical presentation depends on the etiology of the VVF. A VVF secondary to a bladder laceration typically presents immediately. Approximately 90% of genitourinary fistulas associated with pelvic surgery are symptomatic within 7 – 30 days postoperatively. 6,7 An anterior vaginal wall laceration associated with obstetric fistulas typically (75%) presents in the first 24 hours of delivery. 5,8 Although vesicovaginal fistulas (VVF) are the most commonly acquired fistulas of the urinary tract, we lack a standardized algorithm for their management 9 Multiple different surgical