Minimal Access, Optimal Dryness: A Review of Laparoscopic Repair of Vesicovaginal Fistula

Abstract

Background: Vesicovaginal fistula (VVF) is an embarrassing condition for women. Various routes of surgical intervention exist for the management of VVF. Laparoscopic repair is safe and effective. Aim and objective: To review the success rate of laparoscopic repair of VVF and to highlight the benefits/advantages of the laparoscopic approach. Materials and methods: Using various databases, previous studies of patients who underwent laparoscopic VVF repair between 2008 and 2018 were reviewed. Outcome measures from these studies were success rate, mean blood loss, mean operating time, length of hospital stay, major intraoperative complications, and conversion to open surgery. Results: Fourteen retrospective studies (full-text articles) were retrieved and reviewed. Two hundred and sixty-nine patients had a laparoscopic repair. The pooled success rate was 96.7%. Mean blood loss ranged from 30 to 400 mL, length of hospital stay ranged from 1.1 to 7.8 days while the mean operating time ranged from 54 to 229 minutes. There was only one major intraoperative complication. Only four patients had to be converted to open surgery. Conclusion: Laparoscopic repair of VVF has a high success rate and is a safe, patient-friendly, and cost-effective route for surgical management of VVF.