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Simple and effective: transvaginal vesico-vaginal fistula repair with a modified Latzko technique
Olivia Cardenas-Trowers1, John Heusinkveld2, Kenneth Hatch2
1Department of Obstetrics and Gynecology, University of Arizona, 1501 North Campbell Avenue, PO Box 245078, Tucson, AZ, 85724, USA. ocardenastrowers@obgyn.arizona.edu.
Introduction And Hypothesis:
The incidence of vesico-vaginal fistulas after hysterectomies for benign indications in developed countries is less than one percent. The objective of this video is to demonstrate an easy-to-follow, step-by-step approach to repairing a small, uncomplicated vesico-vaginal fistula transvaginally using a modified Latzko technique.
Methods:
In this video, we present a case of a 46-year-old woman who developed a simple, uncomplicated vesico-vaginal fistula after a total abdominal hysterectomy. To correct her fistula, we used a modified Latzko technique, which is a transvaginal approach to vesico-vaginal fistula repair that involves mobilizing the vaginal mucosa around the fistula and then closing the pubo-vesical fascia and vaginal mucosa in layers.
Results:
The patient had successful surgical correction of her vesico-vaginal fistula without recurrence of the fistula.
Conclusions:
For small, uncomplicated vesico-vaginal fistulas, a transvaginal approach has an equivalent success rate to that of other approaches with less invasiveness and faster recovery times. Therefore, it is reasonable to use a modified Latzko technique to help restore the quality of life to women affected by small, uncomplicated vesico-vaginal fistulas.
