Laparoscopic vesicovaginal fistula repair.

OBJECTIVES

Vesicovaginal fistulas are uncommon and remain a surgical challenge. Abdominal hysterectomy remains their main cause. We present our experience in laparoscopic repair of vesicovaginal fistula.

METHODS

Between January 2006 and January 2008, 8 laparoscopic transvesical procedures for VVF repair were performed at our institution (O'Connor technique). For each case we analyzed demographic and surgical variables as well as the outcome. Surgical technique is also described.

RESULTS

Average patient age was 45 years. All patients had past history of hysterectomy and subsequent history of urine leak through vagina, with a mean evolution time of 22 months. The average operative time was 150 minutes and the mean hospital stay 4.7 days. All patients evolved without complications except one who had urinary tract infection (Pseudomonas aeruginosa) that was treated with antibiotics. After a mean follow up of 32 months, there were no recurrences.

CONCLUSION

In experienced hands, transvesical transabdominal laparoscopic vesicovaginal fistula repair is a feasible and safe procedure, preserving all the advantages of minimally invasive surgery.