Risk factors of complications after plastics of vesico-vaginal fistulas with a preoperative application of autoplasma, enriched with platelets

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DOI: 10.29188/2222-8543-2020-13-4-106-113

V.L. Medvedev, A.M. Opolsky, M.I. Kogan
№4 2020

Introduction. Vesicovaginal fistula, or VVF, is one of the most urgent and sociomedically significant problems in modern urology. As of today, more than three million women suffer from VVF worldwide.

Purpose of the study. To evaluate the risk factors for complications in a group of patients with VVF operated with the preliminary use of platelet-rich plasm, or PRP.

Materials and methods. Study included 22 patients who underwent surgical closure of VVF in period from 2011 to 2018 with the preliminary preparation of PRP tissues. A total of 22 patients were divided into two groups: the 1st group included 14 patients who had no complications, while the 2nd group included eight women with developed complications.

Results. Statistically significant differences in the assessment of clinical characteristics of patients in the two groups were observed for the following indicators: duration of hospitalization (p<0.01), duration of bladder drainage (p<0.01). Urinary tract infection, or UTI, was identified more often in the group with complications (p<0.05). Presence of hypertension (p<0.05), pain syndrome (p<0.05), macrohematuria (p<0.05). Statistically significant differences in the assessment of characteristics of vesicovaginal fistula of patients in the two groups were observed for four indicators: distance between the fistula and the internal urethral orifice (p<0.05), the largest diameter of the fistula (p<0.05), the stage of сicatrization (p<0.05), the diameter of the fistula before surgical treatment (p<0.01).

Conclusion. Results of the study dictate the need for an operating surgeon to carefully select the timing and volume of surgical treatment, taking into account many factors mentioned above. Patients should be made aware in detail of possible complications that might arise following VVF fistuloplasty and the reasons for their development in order to adequately prepare for surgical treatment, compensate for concomitant diseases, optimize tissues and blood vessels for better healing of the postoperative wound.

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