Recently, the Urogynecology Team of Western China Hospital published the original article named Transvaginal Repair of vesicovaginal Fistula (impact factor 17.581) in the "Surgery in Motion" column of European Urology, the world's top urology journal. The first author and corresponding author are Prof. Luo Deyi and Prof. Shen Hong, respectively, who work in the Urology Department, and the first author’s institute is West China Hospital, Sichuan University.
Currently, 80% of the vesicovaginal fistula cases in China are attributable to the gynecological surgery, especially the radical hysterectomy, which incidence rate of VVF is about 0.1%-0.2%. Despite of the fact that there is no epidemiological investigation on the large vesicovaginal fistula in China, the clinical trend has shown that vesicovaginal fistula in China is mainly correlated with gynecological surgery. The quality of life of these patients are seriously decreased, often leading to medical disputes. How to deal with vesicovaginal fistula quickly and effectively is a hot research topic. After gynecological surgery, the vesicovaginal fistula usually locate at the unhealed vagina vault. According to the standard practice of Latzko operation (classical vesicovaginal fistula’s repair technique), it is difficult to heal due to the complicated scarl. Moreover, if the fistula is recessed in the top angle of the vagina, it can not be reached by Latzko operation.
Based on a large number of clinical practice, Prof. Shen Hong's team proposed a "Deep Burying technique" to deal with such fistula on the vaginal vault. The "Deep Burying technique" was originated from the idea of maintaining the fistulous tract in Latzko operation and closing vagina in Sims operation. By adopting an innovative vaginal fistula repair operation method for patients with fistula on the vaginal vault, the entire vault vagina, including the fistula opening, is deemed as a free entirety, and a circular incision is made around the normal vaginal wall; redundant scar tissue around the fistula opening is cut away, and the mattress-suture shall be done for the fistula and surrounding vaginal tissue to achieve the satisfactory effect of "Deep Burying". Through follow-up of 108 cases with such disease for 4 years, it is concluded that "Deep Burying technique" repair of the vesicovaginal fistula is simple and easy to operate for relevant patients. The publication of this research marks the international recognition of the "Deep Burying technique" proposed by Prof. Shen for the repair of the vesicovaginal fistula. This is also the key progress of the "Integrated Treatment of Female Pelvic Dysfunction of Urology Department", which is supported by the 135 disciplines’ construction program of the hospital.
As a journal of the European Association of Urology (EAU), European Urology has long been recognized as one of the top journals in urology.
Prof. Shen Hong is currently the honorary head of the female urology group of the Chinese Urological Association. The sub-discipline of gynecology and urology in WCH, established in 2005, was the first sub-discipline in domestic hospitals. Currently, it has been developed into a most influential leading sub-discipline with the most standardized clinical treatment, most systematic education& training and most abundant case resources in China. With the strong support of the hospital, the urogynecology team makes continuous efforts to deepen its clinical research to innovate the surgical methods and obtain breakthrough achievements. This paper is also the first article published in European urology by the Mainland’s urogynecologist.
The link of the article: https://www.europeanurology.com/article/S0302-2838(19)30289-1/fulltext
