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Vesicovaginal Fistula: Minimally Invasive Surgery (MIS) Approaches

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Urinary Fistula

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Abstract

Vesicovaginal fistula is a distressing condition that affects up to 2% of women worldwide, with developing countries leading most of the cases. Transabdominal techniques in vesicovaginal fistula repairs have evolved and now include minimally invasive approaches. Several minimally invasive surgical techniques have been described based on the way that the fistulous tract is approached via vaginal or abdominal (transvaginal, retrovesical, and transvesical). The transabdominal-transvesical approach consists in an intentional cystotomy that is extended toward the fistulous tract. The plane between the bladder and the vagina is subsequently dissected and both organs are closed separately. Lastly, a previously harvested omentum flap is interposed and fixed in place between the bladder and the vagina. While the use of robotic surgery in vesicovaginal fistula repairs is still in its infancy, this approach is especially useful in the setting of complex cases.

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Abbreviations

C-section:

Cesarean section

CT:

Computed tomography

JP:

Jackson-Pratt

MIS:

Minimally invasive surgery

MRI:

Magnetic resonance imaging

VVF:

Vesicovaginal fistula

References

  1. Sotelo R, Moros V, Clavijo R, Poulakis V. Robotic repair of vesicovaginal fistula (VVF). BJU Int. 2012;109(9):1416–34. https://doi.org/10.1111/j.1464-410X.2012.10148.x.

    Article  Google Scholar 

  2. Medina LG, Hernandez A, Sevilla C, et al. Robotic uterine-sparing vesicovaginal fistula repair. Int Urogynecol J. 2018;29(12):1845–7. https://doi.org/10.1007/s00192-018-3720-5.

    Article  Google Scholar 

  3. Wall LL. Obstetric vesicovaginal fistula as an international public-health problem. Lancet. 2006;368:1201–9. https://doi.org/10.1016/S0140-6736(06)69476-2.

    Article  Google Scholar 

  4. El-Azab AS, Abolella HA, Farouk M. Update on vesicovaginal fistula: a systematic review. Arab J Urol. 2019;17(1):61–8. Published 2019 Apr 4. https://doi.org/10.1080/2090598X.2019.1590033.

    Article  Google Scholar 

  5. Bragayrac LAHD, Sotelo RJ. Urinary fistulas. In: Sotelo RAM, Arriaga J, editors. Complications in robotic urologic surgery. Cham: Springer; 2018. p. 285–97.

    Chapter  Google Scholar 

  6. Ghoniem GM, Warda HA. The management of genitourinary fistula in the third millennium. Arab J Urol. 2014;12(2):97–105. https://doi.org/10.1016/j.aju.2013.11.006.

    Article  Google Scholar 

  7. Bodner-Adler B, Hanzal E, Pablik E, Koelbl H, Bodner K. Management of vesicovaginal fistulas (VVFs) in women following benign gynaecologic surgery: a systematic review and meta-analysis. PLoS One. 2017;12(2):e0171554. Published 2017 Feb 22. https://doi.org/10.1371/journal.pone.0171554.

    Article  CAS  Google Scholar 

  8. Miller EA, Webster GD. Current management of vesicovaginal fistulae. Curr Opin Urol. 2001;11:417. https://doi.org/10.1097/00042307-200107000-00014.

    Article  CAS  Google Scholar 

  9. Hadley HR. Vesicovaginal fistula. Curr Urol Rep. 2002;3(5):401–7. https://doi.org/10.1007/s11934-002-0085-5.

    Article  Google Scholar 

  10. Körner SK, Olsen KØ, Jensen JB. Robot-assisted vesicovaginal fistula repair—initial experience. Scand J Urol. 2020;54(2):147–9. https://doi.org/10.1080/21681805.2020.1716846.

    Article  Google Scholar 

  11. Bragayrac LA, Azhar RA, Fernandez G, et al. Robotic repair of vesicovaginal fistulae with the transperitoneal-transvaginal approach: a case series. Int Braz J Urol. 2014;40(6):810–5. https://doi.org/10.1590/S1677-5538.IBJU.2014.06.12.

    Article  Google Scholar 

  12. Medlen H, Barbier H. Vesicovaginal fistula. In: StatPearls [Internet]. Treasure Island, FL: StatPearls; 2021. https://www.ncbi.nlm.nih.gov/books/NBK564389/. Accessed 13 Nov 2020.

  13. Malik MA, Sohail M, Malik MT, Khalid N, Akram A. Changing trends in the etiology and management of vesicovaginal fistula. Int J Urol. 2018;25(1):25–9. https://doi.org/10.1111/iju.13419.

    Article  Google Scholar 

  14. Núñez Bragayrac LA, Azhar RA, Sotelo R. Minimally invasive management of urological fistulas. Curr Opin Urol. 2015;25(2):136–42. https://doi.org/10.1097/MOU.0000000000000144.

    Article  Google Scholar 

  15. Ramphal SR. Laparoscopic approach to vesicovaginal fistulae. Best Pract Res Clin Obstet Gynaecol. 2019;54:49–60. https://doi.org/10.1016/j.bpobgyn.2018.06.008.

    Article  CAS  Google Scholar 

  16. Moses RA, Ann GE. State of the art for treatment of vesicovaginal fistula. Curr Urol Rep. 2017;18(8):60. https://doi.org/10.1007/s11934-017-0708-5.

    Article  Google Scholar 

  17. Sotelo R, Mariano MB, García-Segui A, et al. Laparoscopic repair of vesicovaginal fistula. J Urol. 2005;173(5):1615–8. https://doi.org/10.1097/01.ju.0000154701.97539.ef.

    Article  Google Scholar 

  18. Lightner DJ, Wymer K, Sanchez J, Kavoussi L. Best practice statement on urologic procedures and antimicrobial prophylaxis. J Urol. 2020;203(2):351–6. https://doi.org/10.1097/JU.0000000000000509.

    Article  Google Scholar 

  19. Miklos JR, Moore RD, Chinthakanan O. Laparoscopic and robotic-assisted vesicovaginal fistula repair: a systematic review of the literature. J Minim Invasive Gynecol. 2015;22(5):727–36. https://doi.org/10.1016/j.jmig.2015.03.001.

    Article  Google Scholar 

  20. Nezhat CH, Nezhat F, Nezhat C, Rottenberg H. Laparoscopic repair of a vesicovaginal fistula: a case report. Obstet Gynecol. 1994;83(5 Pt 2):899–901.

    CAS  Google Scholar 

  21. Zumrutbas AE, Ozlulerden Y, Alkis O, Baser A, Aybek Z. Optic-guided vaginal repair of vesicovaginal fistula. J Endourol. 2014;28(3):275–9. https://doi.org/10.1089/end.2013.0435.

    Article  Google Scholar 

  22. O’Conor VJ, Sokol JK. Vesicovaginal fistula from the standpoint of the urologist. J Urol. 1951;66(4):579–85. https://doi.org/10.1016/s0022-5347(17)74381-9.

    Article  Google Scholar 

  23. Melamud O, Eichel L, Turbow B, Shanberg A. Laparoscopic vesicovaginal fistula repair with robotic reconstruction. Urology. 2005;65(1):163–6. https://doi.org/10.1016/j.urology.2004.09.052.

    Article  CAS  Google Scholar 

  24. Hasson HM. A modified instrument and method for laparoscopy. Am J Obstet Gynecol. 1971;110(6):886–7. https://doi.org/10.1016/0002-9378(71)90593-x.

    Article  CAS  Google Scholar 

  25. Paparel P, Caillot JL, Perrin P, Ruffion A. Surgical principles of omentoplasty in urology. BJU Int. 2007;99(5):1191–6. https://doi.org/10.1111/j.1464-410X.2007.06869.x.

    Article  Google Scholar 

  26. Barski D, Gerullis H, Ecke T, et al. Repair of a vesico-vaginal fistula with amniotic membrane - Step 1 of the IDEAL recommendations of surgical innovation. Cent Eur J Urol. 2015;68(4):459–61. https://doi.org/10.5173/ceju.2015.683.

    Article  CAS  Google Scholar 

  27. Price DT, Price TC. Robotic repair of a vesicovaginal fistula in an irradiated field using a dehydrated amniotic allograft as an interposition patch. J Robot Surg. 2016;10(1):77–80. https://doi.org/10.1007/s11701-015-0546-8.

    Article  Google Scholar 

  28. Daley SMLC, Swanson SK, Novicki DE, Itano NB. Fibrin sealant closure of a persistent vesicovaginal fistula after failed transabdominal closure. J Pelvic Med Surg. 2006;12(4):229–30.

    Article  Google Scholar 

  29. Sawant AS, Kasat GV, Kumar V. Cyanoacrylate injection in management of recurrent vesicovaginal fistula: our experience. Indian J Urol. 2016;32(4):323–5. https://doi.org/10.4103/0970-1591.189719.

    Article  Google Scholar 

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Author information

Authors and Affiliations

  1. USC Institute of Urology, University of Southern California, Los Angeles, CA, USA

    Aref S. Sayegh, Luis G. Medina & René Sotelo

  2. Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, USA

    Aref S. Sayegh, Luis G. Medina & René Sotelo

Authors
  1. Aref S. Sayegh
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  2. Luis G. Medina
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  3. René Sotelo
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Editor information

Editors and Affiliations

  1. Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, USA

    René Sotelo

  2. Capital Health – Urology Specialists, Capital Health Medical Center, Pennington, NJ, USA

    Charles F. Polotti

  3. School of Medicine and Health Sciences, Universidad de Sonora, Hermosillo, Mexico

    Juan Arriaga

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Sayegh, A.S., Medina, L.G., Sotelo, R. (2022). Vesicovaginal Fistula: Minimally Invasive Surgery (MIS) Approaches. In: Sotelo, R., Polotti, C.F., Arriaga, J. (eds) Urinary Fistula. Springer, Cham. https://doi.org/10.1007/978-3-031-15317-4_11

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  • DOI: https://doi.org/10.1007/978-3-031-15317-4_11

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  • Online ISBN: 978-3-031-15317-4

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