International Urogynecology Journal

, Volume 4, Issue 3, pp 141–145 | Cite as

Transvaginal repair of vesicocervical fistulae — A forgotten method by Volkovich-Küstner?

  • W. Fischer
Original Article


The vaginal approach to vesicocervical fistulae by N. Volkovich [1] and O. Küstner [2] was characterized by the use of an artificial uterine descensus to achieve collapse and cushioning of the bladder defect. Over the past 35 years, this principle has been applied to 22 vesicouterine fistulae on 12 occasions. The technique is described in detail. Separation of the fistular canal is today followed by closure of the tract in both the bladder and the cervix. Sometimes, interposition of peritoneum was added (n=6). The method was primarily suitable for uncomplicated vesicocervical fistulae (n=4) or for vesicocervicovaginal fistulae (n=8) with the uterine corpus still present and to be preserved. However, if subtotal hysterectomy had been performed before (n=6), transvaginal extirpation of the remaining cervix and a bladder repair would be necessary. On the other hand, vagino-abdominal hysterectomy and bladder repair were unavoidable in cases of vesicocervicocorporeal fistulae (n=3) and in 1 case of vesicocervicovaginal fistula with a severely distorted cervix. Therapy was successful in all cases.


Fistula surgery Transvaginal approach Vesicouterine fistulae 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Volkovich N. Eine plastische Methode, schwer operable vesicovaginale Fisteln durch den Uterus zu verschließen.Zentral bl Gynäkol 1901;25:1193–1200Google Scholar
  2. 2.
    Küstner O. Die plastische Verwendung der Portio supravaginalis zum Verschluß von Blasenscheidenfisteln.Z Geburtsh Gynäk 1903;48:453–463Google Scholar
  3. 3.
    Fischer W. Langzeitanalyse über Ursachen, Lokalisation und Behandklungsergebnisse von Urogenitalfisteln an der CharitéFrauenklinik.Zentral bl Gynäkol 1990;112:747–755Google Scholar
  4. 4.
    Kunz J. Urological complications in gynecological surgery and radiotherapy. In: Keller PJ ed. Contributions to gynecology and obstetrics, Vol 11 Basel: Karger 1984Google Scholar
  5. 5.
    Jonas U, Petri E. Genitourinary fistulae. In: Stanton SL ed. Clinical gynecologic urology. St. Louis/Toronto: Mosby 1984, 238–255Google Scholar
  6. 6.
    Zacharin RF. Obstetric fistula. Wien: Springer 1988, 221Google Scholar
  7. 7.
    Stoeckel W. Gynäkologische Urologie. In: Veit-Stoeckel eds. Handbuch der Gynäkologie. München: Bergmann 1938Google Scholar
  8. 8.
    Kraatz H, Fischer W. Gynäkologisch-urologische Operationen. In: Heise-Hienzsch eds. Urologische Operationslehre Leipzig: Thieme 1972Google Scholar
  9. 9.
    Lawson JB, Hudson CN. The management of vesicovaginal and urethral fistulae. In: Stanton SL, Tanagho EA eds. Surgery of female incontinence. Berlin: Springer 1980, 160Google Scholar
  10. 10.
    Falk HC, Tancer ML. Management of vesical fistulas after cesarean section.Am J Obstet Gynecol 1956;71:97–106Google Scholar

Copyright information

© The International Urogynecology Journal 1993

Authors and Affiliations

  • W. Fischer
    • 1
  1. 1.Department of Obstetrics and GynecologyHumboldt-Universität zu BerlinCharitéGermany

Personalised recommendations