Early Versus Delayed Laparoscopic Repair of Surgically Induced Vesicovaginal Fistula

The optimal timing of surgical repair for vesicovaginal fistula (VVF) remains debated, with traditional recommendations favoring delayed intervention. Whether early laparoscopic repair can achieve comparable outcomes without increasing morbidity is clinically relevant.

This study aimed to compare the clinical efficacy and safety of early (within 3 weeks) versus delayed (≥3 months) laparoscopic VVF repair following surgical injury.

A retrospective cohort study was conducted involving 23 patients with surgically induced VVF treated between January 2021 and December 2024. Patients were categorized into group A (early repair, n = 11) and group B (delayed repair, n = 12). The primary outcome was the surgical success rate, defined as complete resolution of vaginal leakage with cystoscopic confirmation of closure at 3-month follow-up. Secondary outcomes included operative time, estimated blood loss, length of hospital stay, and complication rates.

No significant differences were observed in baseline characteristics, including age, body mass index, or fistula location. The surgical success rates were 90.9% (10 of 11) in group A and 91.7% (11 of 12) in group B (P > 0.99). Operative time, intraoperative blood loss, length of hospital stay, and postoperative complication rates were comparable between the 2 groups. Correlation analysis revealed expected clinical relationships, with operative time and blood loss showing a strong positive association (r = 0.62).

Early laparoscopic VVF repair (within 3 weeks) demonstrates comparable efficacy and safety to delayed repair (≥3 months). The superior visualization provided by laparoscopy is critical for successful early intervention. Early surgical management avoids prolonged patient suffering and represents a viable treatment option for surgically induced simple VVF.