Laparoscopic transvesical approach for vesicovaginal fistula repair

To access the technical feasibility of performing laparoscopic repair of vesicovaginal fistula.

We attempted a laparoscopic repair of vesicovaginal fistula in five women with a history of urinary leakage via the vagina after vaginal hysterectomy. Five pelvic ports were used. The surgical procedure was performed using the same principles as for open surgery, i.e., separation of the vaginal wall from the bladder wall, repair of the fistula, and interposition of the omentum.

There was early recovery of the patients in terms of continence, with less chance of recurrence. Results were comparable to those with the vaginal approach.

The use of minimally invasive surgery for vesicovaginal fistula repair helps to ease the suturing deep in the pelvis, and the magnification facilitates good identification of tissues planes and thus better mobilization of the vaginal and bladder walls and decreases postoperative morbidity.