Recurrent vesico-cervical fistula: our experience.

Area of Science:

• Urology
• Gynecology
• Surgical Innovation

Background:

• Vesico-cervical fistula (VCxF) is a rare genitourinary tract complication.
• Common causes include prolonged labor, cesarean sections, and traumatic injuries.

Purpose of the Study:

• To describe the management of a challenging recurrent vesico-cervical fistula (VCxF).
• To highlight the efficacy of a transabdominal surgical approach in a complex case.

Main Methods:

• A 31-year-old patient with recurrent VCxF after failed robotic repair and cystoscopic fulguration underwent a repeat transabdominal repair.
• Intraoperative localization via guidewire, mini cystostomy, dissection, cervicovaginal layer closure, omental interposition, and cystotomy closure were performed.

Main Results:

• The postoperative recovery was uneventful.
• The patient remained asymptomatic with successful fistula closure at 6-month follow-up.

Conclusions:

• Diagnosing and repairing VCxF presents significant challenges.
• Transabdominal repair is preferred over transvaginal repair for VCxF.
• Minimally invasive surgical techniques (laparoscopic/robotic) offer improved postoperative outcomes for VCxF repair.