Laparoscopic intraperitoneal repair of high-up urinary bladder fistula: a review of 12 cases.

Conventional abdominal operations for urinary bladder fistula have limitations like increased morbidity, more hemorrhage, more postoperative pain, and longer hospital stay. Laparoscopic repair of bladder fistula was done to explore the potential role of laparoscopic surgery in this field. Twelve women with vesicovaginal (11) and vesicouterine (one) fistula, of both gynecological (seven) and obstetric (five) origins, were treated by laparoscopic intraperitoneal repair between 1991 and 2004. The bladder wall was mobilized and repaired by interrupted stitches in single-layer followed by omental interposition. All cases were completed laparoscopically without any significant intra- or postoperative complication. Gynecological cases were discharged on the fourth day. Urinary catheters of all women were removed on the 14th day, and all but one obstetric fistula (91% success) were closed. Long-term follow-up confirmed the cure. Laparoscopic repair is an excellent method of repairing urinary bladder fistula located near the vaginal apex.