V174 TRANSPERITONEAL EXTRAVESICAL LAPAROSCOPIC REPAIR OF VESICOUTERINE FISTULA

Abstract

You have accessJournal of UrologyFemale Voiding Dysfunction (Pelvic Reconstruction & Incontinence)1 Apr 2010V174 TRANSPERITONEAL EXTRAVESICAL LAPAROSCOPIC REPAIR OF VESICOUTERINE FISTULA Aly Abdel-Karim, Ahmed Mosa, Mohamed Hasona, and Salah Elsalmy Aly Abdel-KarimAly Abdel-Karim More articles by this author , Ahmed MosaAhmed Mosa More articles by this author , Mohamed HasonaMohamed Hasona More articles by this author , and Salah ElsalmySalah Elsalmy More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2010.02.229AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES To date there are few reports of successful laparoscopic repair of vesicouterine fistula. We present a video that shows the technique of transperitoneal extravesical laparoscopic repair of vesicouterine fistula. METHODS The patient is 29 years female that presented with Youssef, syndrome following her 2nd cesarean section. Computed tomography (CT) of the abdomen and pelvis and cystoscopy revealed a supratrigonal vesicouterine fistula. The fistula was repaired through laparoscopic transperitoneal extravesical approach using 4 ports. The fistulas tract was identified and completely excised extravesically using sharp dissection. The edge of the bladder was excised at the site of fistulas tract. The urinary bladder was closed in a single layer using 3/0 vicryl continuous suture, while the uterine rent was closed with interrupted 2/0 vicryl suture. An omental flap was interposed between the bladder and the uterus. The urinary bladder was drained by an indwelling urethral catheter for 10 days. RESULTS The operative time was 180 minutes. Blood loss was 50c.c. There were no intraoperative or postoperative complications. Postoperative hospital stay was 2 days. Follow up CT scan of the abdomen and pelvis and cystoscopy 3 months following the repair revealed good healing of the repaired area of the urinary bladder. Clinically, the patient has no cyclic hematuria any more. CONCLUSIONS Transperitoneal extravesical laparoscopic repair of vesicouterine fistula appears to be a safe and effective procedure that adheres to the principles of transabdominal open surgical repair with decreasing morbidity and better cosmoses. However, the technique requires good laparoscopic skills. Alexandria, Egypt© 2010 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 183Issue 4SApril 2010Page: e70 Advertisement Copyright & Permissions© 2010 by American Urological Association Education and Research, Inc.MetricsAuthor Information Aly Abdel-Karim More articles by this author Ahmed Mosa More articles by this author Mohamed Hasona More articles by this author Salah Elsalmy More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...