Abstract
Introduction: We report our series of patients with VVF treated by transvesicoscopic approach. We analyzed the outcome of this repair in women of reproductive age group. Materials and methods: Patients of reproductive age group with VVF formed the study group. Only single fistulas which were <10 mm in diameter and situated in the supratrigonal region were included. Patients were randomized to undergo either laparoscopic transperitoneal or transvesicoscopic repair. Results: During the study period Jan 2009 to Dec 2012, 15 women underwent laparoscopic repair of VVF. Eight of these women underwent laparoscopic transperitoneal repair, whereas the remaining seven underwent transvesicoscopic repair. Conclusions: Transvesicoscopic as well as laparoscopic transperitoneal repair of VVF carries all the advantages of laparoscopy including minimal invasiveness, less morbidity, shorter hospital stay, early recovery, and better cosmetic appearance. Women in the reproductive age group return to early sexual activity and have a decreased incidence of urinary voiding dysfunction at 6 months follow-up.
Highlights
IntroductionWe report our series of patients with VVF treated by transvesicoscopic approach
Women in the reproductive age group return to early sexual activity and have a decreased incidence of urinary voiding dysfunction at 6 months follow-up
The physical and psychological impact of constant urinary leakage from a VVF can be overwhelming due to the burden of continual wetness, undesirable odor, vaginal and bladder infections and their related discomfort.The goal of treatment of VVF is the rapid cessation of urinary leakage with return of normal and complete urinary and genital function [1]
Summary
We report our series of patients with VVF treated by transvesicoscopic approach. Compared with the O’Conortrans abdominal approach, laparoscopic repair is reported to be associated with less surgical trauma, shorter convalescence, and lower morbidity [2,3,4]. Nerli and Reddy [4] reported on the feasibility, safety and effectiveness of the transvesicoscopic approach. This approach had the additional advantage of not needing to enter the peritoneal cavity. Advantages to the robotic technique include three-dimensional visualization, wristed instrumentation reducing the severe angulation required for laparoscopic VVF repair, and technically simpler intracorporeal knot tying
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