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Modified laparoscopic abdominal vesico-vaginal fistula repair--"Mini-O'Conor" vesicotomy
Syed Jamal Rizvi1, Rahul Gupta, Suhag Patel
1Department of Urology and Transplantation Surgery, Institute of Kidney Diseases and Research Center, Ahmedabad, India.
Aim:
The aim of this work was to report on our experience with the laparoscopic repair of vesicovaginal fistulae and describe a modification in technique.
Patients And Methods:
Between 2004 and 2008, 8 patients underwent laparoscopic repair of vesicovaginal fistula. All patients had fistulae secondary to gynecologic surgery. Two patients had undergone previous failed attempts at repair. The mean interval prior to repair was 3.5 months. Patient underwent repair by using a limited cystotomy.
Results:
The operation was successfully completed in all cases. Mean operative time was 145 minutes, and mean estimated blood loss 60 mL. There were no complications. Catheter removal was done at 14 days. All patients were continent after catheter removal and remained continent at a mean follow-up of 29 months.
Conclusion:
Laparoscopic repair of vesicovaginal fistula is safe and effective. Bivalving of the bladder may be avoided by use of a small cystotomy, with the potential benefits of shorter operative time and reduced bladder spasms.