[Vesicovaginal fistulas--current therapeutical strategy]

Area of Science:

• Urology
• Gynecology
• Surgical Innovation

Context:

• Vesicovaginal fistulas (VVF) pose significant challenges in gynecological and urological practice.
• Recurrent or complex fistulas often require specialized surgical interventions.
• Previous treatment failures necessitate exploring alternative therapeutic strategies.

Purpose:

• To evaluate the clinical efficacy of the Latzko operation for primary and recurrent vesicovaginal fistulas.
• To present an updated therapeutic strategy for managing these complex cases.
• To assess the Latzko operation's success rate, particularly in patients with a history of failed abdominal surgeries.

Summary:

• The Latzko operation was performed on 6 patients (5 with VVF, 1 with urethrovaginal fistula), including those with prior unsuccessful fistula repairs.
• Successful fistula closure was achieved in all 5 VVF patients, with one requiring a repeat procedure.
• An additional Martius flap was utilized in two cases, demonstrating the adaptability of the surgical approach.

Impact:

• The Latzko operation, utilizing a vaginal approach, demonstrates high therapeutic efficacy for vesicovaginal fistulas.
• This method offers a viable and successful treatment option for recurrent fistulas, even when prior abdominal interventions have failed.
• Highlights the importance of vaginal surgical techniques in managing complex fistula cases.