Review of Experience with Vesicovaginal Fistula Repair

Abstract

Experience with suprapubic closure of vesicovaginal fistulas in 42 patients considered candidates for this procedure is reviewed. Five patients required a second operation for cure and the reasons for failure are discussed. Wide exposure with tension-free closure of well vascularized flaps and the judicious interposition of pedicled omentum have produced the most encouraging results. The litigious nature of this distressing condition is lessened when primary closure is successful and supravesical diversion by ileal or colonic conduits can be avoided.

Eighteen Years Old Vesico-Vaginal Fistula Caused by Forceps Delivery: A Saga of Suffering

“…In our society many such women are neglected and malnourished, suffering from untreated urinary infections and anemia. Deferring surgery in such women allows tissue to recover and treat infection 10 . However a woman with urinary fistula not seeking medical care for 18 years, directly points towards her loss of faith in the health care system.…”

Laparoscopic treatment of a vesico-vaginal fistula: A new approach

“…The gold standard technique for posterior supratrigonal fistulas is the one described by O'connor, [5] in which the fistula is accessed using a transvaginal approach. An anterior cystostomy is performed in order to get to the fistula, localized at a posterior level, and perform a complete resection.…”

Reparación laparoscópica de la fístula vesicovaginal (O'Connor laparoscópico)

“…En nuestro medio, la causa más frecuente de fístula vesicovaginal es la histerectomía [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18] . Toda complicación quirúrgica que se pone de manifiesto de forma diferida e implica una resolución tardía añade unas connotaciones, no sólo desde un punto de vista médico, que la convierten en un problema especialmente peliagudo.…”

“…Como consecuencia de esta dedicación, son muchos los procedimientos quirúrgicos descritos para resolverlas [1][2][3][4] . Actualmente la mayoría de los abordajes se hacen por vía vaginal; el abordaje por vía abdominal conocido como fistulorrafia vesicovaginal de O'Connor es el procedimiento descrito con mayor tasa de éxito (superior al 95%) y con el que deberíamos comparar cualquier otro procedimiento 5 .…”