8190 Laparoscopic Management of Large Vesico-Vaginal Fistula(VVF)- Case Report

Abstract

Study Objective To repair Vesico-Vaginal Fistula (VVF) laparoscopically. Design Case presentation of laparoscopic surgical correction of VVF. Setting Tertiary care laparoscopic center. Patients or Participants A case of VVF that came to us post open hysterectomy with continuous dribbling of urine was included. Specific history was taken. Diagnosis of VVF was made with Vesico-fistulogram. Size was 8 mm. Interventions Correction was done 4 months after the hysterectomy. Cystoscopy was done prior to the procedure to look for the location of fistula and the patency of both ureteral orifices. The fistula was at the trigone of the bladder. Conventional laparoscopic repair was done by modified O'Conner's technique under GA. Catheter was placed post-surgery for 4 weeks. Measurements and Main Results We evaluated the post-op patient with regular follow-up after 1, 2 and 4 weeks with scan and urine culture. Patient was put on appropriate antibiotics depending upon the culture report. Catheter removed 4 weeks later, and the patient followed up regularly for vaginal discharge. There was no vaginal discharge. Cystoscopy was done after 2 months, bladder was normal. Conclusion Laparoscopic modified O'Conner's technique for VVF gives a promising outcome and patient satisfaction. To repair Vesico-Vaginal Fistula (VVF) laparoscopically. Case presentation of laparoscopic surgical correction of VVF. Tertiary care laparoscopic center. A case of VVF that came to us post open hysterectomy with continuous dribbling of urine was included. Specific history was taken. Diagnosis of VVF was made with Vesico-fistulogram. Size was 8 mm. Correction was done 4 months after the hysterectomy. Cystoscopy was done prior to the procedure to look for the location of fistula and the patency of both ureteral orifices. The fistula was at the trigone of the bladder. Conventional laparoscopic repair was done by modified O'Conner's technique under GA. Catheter was placed post-surgery for 4 weeks. We evaluated the post-op patient with regular follow-up after 1, 2 and 4 weeks with scan and urine culture. Patient was put on appropriate antibiotics depending upon the culture report. Catheter removed 4 weeks later, and the patient followed up regularly for vaginal discharge. There was no vaginal discharge. Cystoscopy was done after 2 months, bladder was normal. Laparoscopic modified O'Conner's technique for VVF gives a promising outcome and patient satisfaction.