Cirugía laparoscópica de la fístula vesico-vaginal: resultados de una experiencia multi-institucional

Abstract

Laparoscopic surgery of vesicovaginal fistula: results of a multi institutional experienceIntroduction: Vesico-vaginal fistula is a rare complication of gynecologic surgery, with a high rate of surgical resolution O'Conor open technique. Aim: To report the results of a multi-institutional experience in laparoscopic repair of vesico-vaginal fistula. Material and Methods: Between January 2006 and June 2011, 21 laparoscopic vesico-vaginal fistula were performed. The surgical technique, demographic variables and results are described. Results: The mean age was 45.6 years. The average time between the diagnosis of the fistula and the laparoscopic repair was 15.23 months. The mean total operative time (bladder and laparoscopic) was 153.12 minutes and the average hospital stay was 2.7 days. The average time of bladder catheter was 9.4 days. There was a minimal recurrence of a fistula, repaired by a vaginal approach. Urethrocystography revealed indemnity of the repair in the other 20 cases. The overall success rate was 95.2% (20 out of 21 patients) Conclusions: The laparoscopic approach follows all principles for repair of a vesico-vaginal fistulas. It look like a good alternative in the hands of experienced surgeons.

Reparación quirúrgica por vía vaginal de fístulas vesicovaginales: una experiencia exitosa

“…Algunas situaciones en que se podría preferir la vía transabdominal son los casos de importante estenosis vaginal, necesidad de otros procedimientos abdominales o pélvicos concomitantes (p. ej., fístula compleja que involucra uréter, intestino o cuello uterino) o por preferencia del cirujano 4,6 .…”