Revisiting Conservative Management of Vesicovaginal Fistula

Abstract

The incidence of vesicovaginal fistula is the greatest with laparoscopic hysterectomies [ 1 Lee R.A. Symmonds R.E. Williams T.J. Current status of genitourinary fistula. Obstet Gynecol. 1988; 72: 313-319 PubMed Google Scholar ]. A 48-year-old woman underwent a robot-assisted total laparoscopic hysterectomy with benign pathology. One month postoperatively she presented with a 1-cm vesicovaginal fistula (Fig. A,B). Its size was visually estimated on cystoscopy and vaginal exam. This was managed conservatively with bladder drainage. To rule out an associated ureterovaginal fistula, computed tomography urography was done (Fig. C,D) [ 2 Goodwin W.E. Scardino P.T. Vesicovaginal and ureterovaginal fistulas: a summary of 25 years of experience. J Urol. 1980; 123: 370-374 Abstract Full Text PDF PubMed Google Scholar ]. Spontaneous healing was confirmed after 6 weeks of drainage.