Colpocleisis in vesico-vaginal radiation fistula.

OBJECTIVE

To assess Latzko's colpocleisis with bilateral Martius flap as a solution for vesico vaginal fistula secondary to radiotherapy.

METHOD: 65 year old woman with past medical history of cervix adenocarcinoma treated with hysterectomy, pelvic radiotherapy and brachytherapy. She also had terminal colostomy for recto-vaginal fistula. She complained of a 2-year history of continuous urinary escape through vagina. On cistoscopy, the ureteral orifices were close to the loss of substance. Colpocleisis following Latzko's technique was performed.

RESULTS

Complete resection of the fistulous tract and tension free closure is a surgical challenge not always achieved, and with a high recurrence rate. Latzko's colpocleisis is a simple and safe option in patients that have previously undergone a hysterectomy. Bilateral Martius flap increases vascular support of the affected tissues, which is of pivotal importance in patients subjected to radiotherapy.

CONCLUSION

Latzko's colpocleisis is a valid therapeutic option in those histerectomised patients with vesico vaginal fistulas due to radiotherapy who are not eligible for fistulorraphy.