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The following is a summary of “Comparison of sterile normal saline and 1% povidone-iodine for vaginal preparation in vesicovaginal fistula: a randomised trial,” published in the February 2025 issue of Journal of Obstetrics and Gynaecology by Che et al. 

Vaginal preparation was found to improve the success of transvaginal gynecological surgeries, but the optimal agent for transvaginal vesicovaginal fistula (VVF) repair remained unclear.  

Researchers conducted a retrospective study to compare irritation symptoms and antimicrobial function between sterile normal saline (SS) and 1% povidone-iodine (PI) for vaginal preparation in the surgical repair of VVF.  

They enrolled individuals with VVF undergoing transvaginal repair. Preoperative vaginal irrigation was randomly assigned to SS or 1% PI. Self-reported symptom questionnaires, including the Numerical Rating Scale (NRS) for pain, Indevus Urgency Severity Scale (IUSS), and vaginal symptoms, were collected. Tissue edema degree and pathogenic microbiology were also recorded.  

The results showed that 30 individuals received SS, and 31 received 1% PI. After 2 preoperative irrigations, the SS group had a similar bacterial species count but a higher bacterial load than the PI group (P = .079, P = .033). Pain scores on the NRS and IUSS were lower in the SS group (P < .001). Vaginal symptoms (P < .001) and tissue edema (P < .001) were also less severe in the SS group. The success rates for surgical repair were 86.7% in the SS group and 83.9% in the PI group (P = .758). Those with more severe urinary and vaginal symptoms had lower success rates (92.3% vs 72.7%, P = .047).  

Investigators concluded that SS was an effective vaginal preparation liquid for transvaginal repair of VVF, demonstrating less irritation and acceptable antimicrobial function. 

Source: tandfonline.com/doi/full/10.1080/01443615.2024.2439356