Vesico-Vaginal Fistula Repair Using Pneumovesicoscopy: A Single Tertiary Care Center Study.

INTRODUCTION AND HYPOTHESIS: Vesico-vaginal fistula (VVF) is an abnormal bladder-vagina communication causing continuous urinary incontinence. This prospective study compares the efficiency and outcomes of pneumovesicoscopy (PV) versus laparoscopy (LA) for repairing simple to intermediate fistulas.

METHODS

Fifty female patients, primarily with iatrogenic simple and intermediate VVF following hysterectomy, were assigned to either the PV group (N = 25) or the LA group (N = 25) at a tertiary care center in India. Evaluated outcomes included operative time, blood loss, hospital stay length, and success rates, defined by a negative two-swab test at follow-up.

RESULTS

The PV group demonstrated significant advantages, including a shorter mean operative time (110.5 ± 25.1 min vs. 175.8 ± 38.7 min, p < 0.001) and lower estimated blood loss (25.1 ± 8.3 mL vs. 40.2 ± 12.5 mL, p < 0.001). Additionally, mean hospital stays were significantly shorter for PV patients (2.1 ± 0.7 days vs. 4.5 ± 1.2 days, p < 0.001). At 3 months, success rates were comparable between the groups, with 88% for PV and 84% for LA (p = 0.500). Complication rates were lower in the PV group (12%) compared to the LA group (28%).

CONCLUSION

Pneumovesicoscopy is a feasible, safe, and effective minimally invasive technique for VVF repair. It provides shorter operative times, reduced blood loss, and quicker recovery while maintaining success rates equivalent to conventional laparoscopy.