Figure 3 - uploaded by Shivayogeeswar Neelagund
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(a) The bladder is bivalved which shows the fistula communication. (b) The tip of suction is introduced into the vesicovaginal fistula. (c) The bladder is closed vertically and omentum is interposed between bladder and vagina
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INTRODUCTION: One of the major complications of vesicovaginal fistula (VVF) surgery is recurrent fistula formation. A repeat repair is undertaken after resolution of the inflammatory response to the initial procedure. We report our experience with recurrent VVF managed at our center.
MATERIALS AND METHODS: We retrospectively reviewed the inpatient/...
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INTRODUCTION: One of the major complications of vesicovaginal fistula (VVF) surgery is recurrent fistula formation. A repeat repair is undertaken after resolution of the inflammatory response to the initial procedure. We report our experience with recurrent VVF managed at our center. MATERIALS AND METHODS: We retrospectively reviewed the inpatient/...
Citations
... It may have a significant impact on the quality of life of the patient affecting medical well-being, psychologic status as well as sexual and social life. Vesicovaginal fistulas are an uncommon problem that occur in 0.5-2.0% of all pelvic surgeries (Nerli et al., 2019). In developing countries 97% of all VVF are secondary to prolonged obstructed labour whereas in industrialised countries the majority of cases present after gynaecological or urological surgery. ...
... In developing countries 97% of all VVF are secondary to prolonged obstructed labour whereas in industrialised countries the majority of cases present after gynaecological or urological surgery. (Bodner-Adler et al., 2017;Nerli et al., 2019). Other risk factors include pelvic irradiation, endometriosis, malignancy, anatomical distortion by myomas or ovarian tumors, impaired healing status and infection (Nerli et al., 2019). ...
... (Bodner-Adler et al., 2017;Nerli et al., 2019). Other risk factors include pelvic irradiation, endometriosis, malignancy, anatomical distortion by myomas or ovarian tumors, impaired healing status and infection (Nerli et al., 2019). ...
Background:
Vesicovaginal fistulas (VVF) are an unusual problem that may significantly affect a patient's quality of life. The main causes for this condition are labour complications (mostly in developing countries) and pelvic surgeries (in industrialised countries). Treatment may be conservative or surgical. Regarding surgical treatment, there is still debate about the best approach and surgical technique.
Objective:
To demonstrate a correction of a VVF guided by cystoscopy using intravesical laparoscopic instruments.
Methods:
Case report and surgical video of a recurrent VVF treated with a hybrid technique involving direct transvesical insertion of 3 mm laparoscopic trocars and instruments guided by cystoscopy. As far as we know, although there are some reported techniques that use a combination of transvesical laparoscopic instruments and cystoscopy, this is the least invasive and most ergonomic technique described.
Results:
Two years after surgery, the patient remains asymptomatic and with no fistula recurrence.
Conclusion:
The transvesical approach guided by cystoscopy seems to be an effective, safe and ergonomic minimally invasive procedure for VVF repair.
