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[VVF: laparoscopic versus open surgical abdominal].

Guillermo Montoya-Martínez¹, Alejandra Georgina Ledesma-Rodríguez¹, Eduardo Serrano-Brambila¹

¹Servicio de Urología, Unidad Médica de Alta Especialidad, Hospital de Especialidades Dr. Bernardo Sepúlveda Gutiérrez, Centro Médico Nacional Siglo XXI, IMSS, México, DF.

Ginecologia Y Obstetricia De Mexico

|February 4, 2014

Summary

Open abdominal surgery for vesicovaginal fistula (VVF) showed a higher success rate than laparoscopic surgery. However, laparoscopic VVF treatment resulted in shorter catheterization and hospitalization times, with less postoperative bleeding.

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Area of Science:

Urology
Gynecologic Surgery
Minimally Invasive Surgery

Background:

Vesicovaginal fistula (VVF) is a common acquired urinary tract fistula causing significant quality of life impairment.
It results from an abnormal connection between the bladder and vagina, leading to transvaginal urine leakage.

Purpose of the Study:

To compare the efficacy and safety of open abdominal versus laparoscopic surgical repair of vesicovaginal fistulas (VVF).

Main Methods:

A retrospective comparative study included patients diagnosed with VVF and followed up for at least 3 months post-surgery.
Patients underwent O'Conor surgical closure, divided into open abdominal (Group I) and laparoscopic (Group II) groups.
Key parameters compared included age, BMI, fistula size/location, operative time, blood loss, and hospital stay.

Main Results:

The study evaluated 27 VVF patients: 18 open abdominal (Group I) and 9 laparoscopic (Group II).
Success rates were 94.4% for open abdominal and 77% for laparoscopic (p>0.05).
Laparoscopic VVF repair demonstrated significant advantages in reduced transurethral catheter duration, shorter hospital stays, and less postoperative bleeding (p<0.05).

Conclusions:

The laparoscopic approach offers a viable alternative to traditional open abdominal surgery for VVF repair.
While effective, laparoscopic VVF surgery necessitates specialized expertise in pelvic laparoscopic procedures.