A Novel Method For Iatrogenic Vesicovaginal Fistula Treatment : Autologous Platelet-Rich-Plasma Injection And Platelet-Rich-Fibrin-Glue Interposition (#344)
Propose: Vesicovaginal fistula (VVF) has
remained one of the difficult challenges to surgical therapy. In this study,
autologous platelet-rich plasma (PRP) and platelet-rich fibrin glue (PRFG) has
been used for VVF closure as a minimally invasive approach.
Materials and Methods: The data including age, parity, ICIQ- UI, ICIQ- QOL, duration of leakage, the diameter of fistula and complications were collected before and after intervention. PRP & PRFG was prepared from 12 patients’ own blood. Deepithelialisation was performed around the fistula till a small amount of hemorrhage was occurred; PRP was injected around the fistula into the tissue and PRFG was interpositioned in the tract.
Results: No complications were observed during and after the injection. Mean age was 39.83±8.40 years. At 3-months' follow up, 11 patients considered themselves clinically cured; transvaginal physical examination and cystography was normal in 11 patients. ICIQ-UI and ICIQ-QOL showed remarkable improvement in 11 patients. One patient had significant improvement, but did not consent to the second injection. None of the patients had voiding dysfunction, urinary incontinence or retention or urinary tract infection.
Conclusions: Autologous PRP injection and PRFG interposition offers a safe, effective and novel minimally invasive approach for VVF treatment which obviates the need for open surgery. We would like to call this technique Hamidi-Shirvan method.
Materials and Methods: The data including age, parity, ICIQ- UI, ICIQ- QOL, duration of leakage, the diameter of fistula and complications were collected before and after intervention. PRP & PRFG was prepared from 12 patients’ own blood. Deepithelialisation was performed around the fistula till a small amount of hemorrhage was occurred; PRP was injected around the fistula into the tissue and PRFG was interpositioned in the tract.
Results: No complications were observed during and after the injection. Mean age was 39.83±8.40 years. At 3-months' follow up, 11 patients considered themselves clinically cured; transvaginal physical examination and cystography was normal in 11 patients. ICIQ-UI and ICIQ-QOL showed remarkable improvement in 11 patients. One patient had significant improvement, but did not consent to the second injection. None of the patients had voiding dysfunction, urinary incontinence or retention or urinary tract infection.
Conclusions: Autologous PRP injection and PRFG interposition offers a safe, effective and novel minimally invasive approach for VVF treatment which obviates the need for open surgery. We would like to call this technique Hamidi-Shirvan method.