Abstract：
BACKGROUND: We aim to compare the clinical and urodynamic profile of lower urinary tract symptoms (LUTS) in patients undergoing laparoscopic, open transabdominal, and laparoscopic transabdominal vesicovaginal fistulae (VVF) repair at 3 months of repair, that is, in early postoperative period.
METHODS: Fifty-one consecutive patients with endoscopically confirmed VVF were enrolled in our study over 2 years. Malignant fistulae, radiation-induced, and complex fistulae were excluded after cross-sectional imaging. All patients underwent a postoperative assessment for the success of the repair. Then at 3 months, they completed the American Urological Association Symptom Score questionnaire and underwent a dual channel pressure-flow urodynamic study. The results of transvaginal, laparoscopic, and open transabdominal repairs were compared.
RESULTS: All patients belonged to the Indian Caucasian race. The mean age was 35.43 ± 6.63 years. Thirty-two patients had supratrigonal and 19 had trigonal fistulae. Laparoscopic transabdominal repair was done in 15 patients, open transabdominal repair in 22 patients, and transvaginal repair in 14 patients. Forty-six patients reported some LUTS at a median follow-up of 5.83 ± 2.37 months postoperatively. Only 18 (35.2%) of these patients had moderate to severe symptoms The postoperative bladder dysfunction rates in open transabdominal, transvaginal and laparoscopic transabdominal groups were 36.4%, 28.6%, and 20%, respectively. Twenty-seven patients (52.9%) had some urodynamic abnormality, that is, small capacity (5), high voiding pressures (14), genuine stress incontinence (3), and poor compliance (3). Bladder capacity was a significant predictor of bladder dysfunction in our patients.
CONCLUSIONS: In our study, all three surgical approaches were associated with bladder dysfunction, however, it was the least in the laparoscopic transabdominal approach. Postoperative bladder capacity is a significant predictor of bladder dysfunction.
METHODS: Fifty-one consecutive patients with endoscopically confirmed VVF were enrolled in our study over 2 years. Malignant fistulae, radiation-induced, and complex fistulae were excluded after cross-sectional imaging. All patients underwent a postoperative assessment for the success of the repair. Then at 3 months, they completed the American Urological Association Symptom Score questionnaire and underwent a dual channel pressure-flow urodynamic study. The results of transvaginal, laparoscopic, and open transabdominal repairs were compared.
RESULTS: All patients belonged to the Indian Caucasian race. The mean age was 35.43 ± 6.63 years. Thirty-two patients had supratrigonal and 19 had trigonal fistulae. Laparoscopic transabdominal repair was done in 15 patients, open transabdominal repair in 22 patients, and transvaginal repair in 14 patients. Forty-six patients reported some LUTS at a median follow-up of 5.83 ± 2.37 months postoperatively. Only 18 (35.2%) of these patients had moderate to severe symptoms The postoperative bladder dysfunction rates in open transabdominal, transvaginal and laparoscopic transabdominal groups were 36.4%, 28.6%, and 20%, respectively. Twenty-seven patients (52.9%) had some urodynamic abnormality, that is, small capacity (5), high voiding pressures (14), genuine stress incontinence (3), and poor compliance (3). Bladder capacity was a significant predictor of bladder dysfunction in our patients.
CONCLUSIONS: In our study, all three surgical approaches were associated with bladder dysfunction, however, it was the least in the laparoscopic transabdominal approach. Postoperative bladder capacity is a significant predictor of bladder dysfunction.
摘要：
背景：我们旨在比较腹腔镜患者下尿路症状（LUTS）的临床和尿动力学特征，开腹,和腹腔镜经腹膀胱阴道瘘（VVF）修复在3个月的修复，也就是说,在术后早期。
方法：在我们的研究中纳入了51例经内镜证实的VVF的连续患者。恶性瘘,辐射诱导，横断面成像后排除了复杂的瘘管.所有患者都接受了修复成功的术后评估。然后在三个月的时候，他们完成了美国泌尿外科协会症状评分问卷,并进行了双通道压力-流量尿动力学研究.经阴道的结果，腹腔镜,与开腹修补术进行比较。
结果：所有患者都属于印度高加索种族。平均年龄35.43±6.63岁。32例患者患有心房上瘘，19例患有三角瘘。腹腔镜经腹修补术15例,开腹修补术22例,经阴道修复14例。46例患者在术后中位随访5.83±2.37个月时报告了一些LUTS。这些患者中只有18例（35.2％）有中重度症状。经腹开放术后膀胱功能障碍的发生率，经阴道和腹腔镜经腹组为36.4%，28.6%,20%,分别。27例患者(52.9%)有一些尿动力学异常,也就是说,容量小（5），高排尿压力(14)，真正的压力性尿失禁（3），依从性差（3）。膀胱容量是我们患者膀胱功能障碍的重要预测指标。
结论：在我们的研究中，所有三种手术方式均与膀胱功能障碍有关，然而,在腹腔镜经腹入路中，这是最少的。术后膀胱容量是膀胱功能障碍的重要预测指标。
方法：在我们的研究中纳入了51例经内镜证实的VVF的连续患者。恶性瘘,辐射诱导，横断面成像后排除了复杂的瘘管.所有患者都接受了修复成功的术后评估。然后在三个月的时候，他们完成了美国泌尿外科协会症状评分问卷,并进行了双通道压力-流量尿动力学研究.经阴道的结果，腹腔镜,与开腹修补术进行比较。
结果：所有患者都属于印度高加索种族。平均年龄35.43±6.63岁。32例患者患有心房上瘘，19例患有三角瘘。腹腔镜经腹修补术15例,开腹修补术22例,经阴道修复14例。46例患者在术后中位随访5.83±2.37个月时报告了一些LUTS。这些患者中只有18例（35.2％）有中重度症状。经腹开放术后膀胱功能障碍的发生率，经阴道和腹腔镜经腹组为36.4%，28.6%,20%,分别。27例患者(52.9%)有一些尿动力学异常,也就是说,容量小（5），高排尿压力(14)，真正的压力性尿失禁（3），依从性差（3）。膀胱容量是我们患者膀胱功能障碍的重要预测指标。
结论：在我们的研究中，所有三种手术方式均与膀胱功能障碍有关，然而,在腹腔镜经腹入路中，这是最少的。术后膀胱容量是膀胱功能障碍的重要预测指标。
