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

Abstract

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.

Keywords

Fistula surgery Transvaginal approach Vesicouterine fistulae 

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Copyright information

© The International Urogynecology Journal 1993

Authors and Affiliations

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

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