Management of recurring vesi-covaginal fistulas by vaginal flap technique

Abstract

Italian

— Since 1990 9 patients with vesi-covaginal fistulae located in the trigonal area of the bladder have been treated using the Leach, Raz transvaginal approach (1983). 6 women had been operated previously (4 women once / 2 women twice). Although it is customary to recommend the transabdominal route when operative repair fails, we preferred the transvaginal technique. When the urethral catheter was removed on the tenth to fifteenth postoperative day, all patients were dry. The outpatient voiding diary documented urgency/frequency syndrome in 2 cases and urinary retention in 1 due to psychosocial causes and neurogenic etiology (previous abdominoperineal resection). This technique is certainly interesting and we recommend it before attempting any abdominal surgical repair in particularly unsuccessful cases because it offers several advantages: excellent exposure, no opening of the bladder, minimal dissection, multilayer closure, reduced postoperative discomfort and shorter hospital stay.

Keywords

fistole vescico vaginali recidive riparazione per via vaginale cateterismo intermittente vesi-covaginal fistulas recurrences transvaginal vesi-covaginal fistula repair intermittent catheterization

Get full access to this article

View all access options for this article.

References

Leach

G.E.

, Raz

: Vaginal flap technique: a method of transvaginal vesico-vaginal fistula repair. In: Female Urology, Ed. Raz

, pp. 372, 1983.

Zanollo

, Catanzaro

: Lesioni urologiche secondarie a trattamenti del carcinoma della cervice uterina. In: Neoplasie Ginecologiche. Ed. Veronesi, Candiani, Di Re, Santoro, pp. 123, 1987.