Abstract
Abstract
Objective:
The goal of this research was to determine the efficacy and safety of laparoscopic treatment of vesicovaginal fistula (VVF).
Materials and Methods:
This was a descriptive, retrospective study of 36 patients with VVF who were treated between 2006 and 2015. This study included patients age 18 or older, with supratrigonal VVF caused by obstetric or surgical injuries, even when they had other lesions of the urinary tract. Patients with VVF located at the trigonal or pretrigonal levels, and who had prior pelvic radiotherapy or contraindications for the laparoscopic approach were excluded. A transperitoneal transvesical approach was utilized, with vesical and vaginal closure in a single layer, with running 2-0 Vicryl suturing, without interposition of other tissues. SPSS version 21 was used for statistical analysis of the data. Measures of central tendency dispersion, absolute frequencies, and percentages were used. The relationship between the intraoperative variables and the recurrent risk of fistula was analyzed. Student's t-test and Fisher's exact test were utilized; p < 0.05 was considered significant.
Results:
The average age was 46.5 years, 94.4% of VVF cases were due to open abdominal hysterectomy. The mean time interval between the appearance of the fistula and surgery was 14.7 months. Average operative time was 140.4 minutes. Average hospital stay was 7.8 days. No conversions to open surgery were required. The surgery was successful in 33 of 36 patients (91.6%). There were 3 complications (11.1%). The Dindo classification was Grade IIIb.
Conclusions:
Repair of VVF with laparoscopic surgery is an effective and safe procedure with a high success rate and is an alternative for treating VVF. (J GYNECOL SURG 33:175)
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