Video of the laparoscopic repair of a vesico-uterine fistula.

AIM: Vesico-uterine fistulas (VUFs) are rare in modern gynecological practice. We aim to demonstrate with a video the surgical techniques involved in laparoscopic repair of a vesico-uterine fistula (Youssef's syndrome).

METHODS

A 37-year-old woman, para 2 and otherwise healthy, was referred to the Urogynaecology Unit 4 months following a vaginal birth after a previous cesarean, with ongoing pink-colored vaginal watery discharge. Cystoscopy and hysteroscopy confirmed the findings of a well-granulated fistulous tract connecting the base of the bladder and anterior uterine wall just above the level of the internal os. She underwent an uncomplicated laparoscopic repair of VUF.

RESULTS

She has remained asymptomatic with resumption of normal menses and no clinical evidence of fistula recurrence at 6-week and 6-month post-operative reviews.

CONCLUSION

This video demonstrates the surgical techniques involved in the laparoscopic repair of a VUF, a rare case in modern gynecological practice where there are few surgical videos demonstrating techniques.