Introduction and hypothesis
Surgical repair of vesicouterine fistula (VUF) can be performed through transvaginal and transabdominal routes. Transvaginal repair of VUF has been rarely reported. This study is aimed at demonstrating the feasibility and experience of transvaginal repair of VUF, and presents a step-by-step concrete surgical technique.
We presented a video of a 36-year-old woman who developed VUF after a second cesarean section. The patient underwent a transvaginal surgical repair in the prone jackknife position. We also presented the clinical data of another two patients with VUF, and summarized the experience of all three patients in whom the same technique was performed.
The operative times of the three patients were 120, 200, and 180 min respectively. No surgical complications were observed. After a follow-up of 2–3.5 years, none of the patients had vaginal leakage.
Transvaginal repair of VUF in the prone jackknife position is a feasible and effective procedure for restoring the anatomy. However, there is still a need for well-designed studies with a large number of patients to identify the most promising approach.
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Kettache R, Merad A, Buchholz NNP. Surgical management of Youssef's syndrome: a case report. Urol Int. 2020;104:833–6. https://doi.org/10.1159/000509205.
Spinelli MG, Lorusso V, Palmisano F, Morelli M, Dell'Orto PG, Tremolada C, Montanari E. Endoscopic repair of a vesicouterine fistula with the injection of microfragmented autologous adipose tissue (Lipogems®). Turk J Urol. 2020;46:398–402. https://doi.org/10.5152/tud.2020.20170.
Hadzi-Djokic JB, Pejcic TP, Colovic VC. Vesico-uterine fistula: report of 14 cases. BJU Int. 2007;100:1361–3. https://doi.org/10.1111/j.1464-410X.2007.07067.x.
Józwik M, Józwik M. Clinical classification of vesicouterine fistula. Int J Gynaecol Obstet. 2000;70:353–7. https://doi.org/10.1016/s0020-7292(00)00247-2.
Smayra T, Ghossain MA, Buy JN, Moukarzel M, Jacob D, Truc JB. Vesicouterine fistulas: imaging findings in three cases. AJR Am J Roentgenol. 2005;184:139–42. https://doi.org/10.2214/ajr.184.1.01840139.
Jóźwik M, Jóźwik M. Spontaneous closure of vesicouterine fistula. Account for effective hormonal treatment. Urol Int. 1999;62:183–7. https://doi.org/10.1159/000030388.
Przudzik M, Borowik M, Łesiów M, Łesiów R, Roslan M. Laparoendoscopic single port transvesical repair of an iatrogenic vesicouterine fistula. A three-year follow-up. Cent European J Urol. 2020;73:387–8. https://doi.org/10.5173/ceju.2020.0169.
Govorov IE, Vorobeva MA, Komlichenko EV. Robotic repair of the symptomatic vesicouterine fistula. Int Urogynecol J. 2021;32(7):1945–7. https://doi.org/10.1007/s00192-020-04558-0.
Milani R, Cola A, Frigerio M, Manodoro S. Repair of a vesicouterine fistula following cesarean section. Int Urogynecol J. 2018;29:309–11. https://doi.org/10.1007/s00192-017-3506-1.
Symeonidis EN, Sdralis E, Symeonidis A, Georgiadis C, Kalyvas V, Malioris A, Papathanasiou M. Vesicouterine fistula (VUF) as a rare urogenital complication managed with delayed surgical repair: a case report and review of the literature. Case Rep Obstet Gynecol. 2018;2018:2394896. https://doi.org/10.1155/2018/2394896.
Lee D, Zimmern P. Vaginal approach to vesicovaginal fistula. Urol Clin North Am. 2019;46:123–33. https://doi.org/10.1016/j.ucl.2018.08.010.
Osman NI, Mangir N, Reeves FA, Franco A, Ricci E, Inman R, Chapple CR. The modified prone jack-knife position for the excision of female urethral diverticula. Eur Urol. 2021;79:290–7. https://doi.org/10.1016/j.eururo.2020.11.016.
Kumar P, Mishra TS, Sarthak S, Sasmal PK. Lithotomy versus prone position for perianal surgery: a randomized controlled trial. Ann Coloproctol. 2021. https://doi.org/10.3393/ac.2020.12.16.
Hemal AK, Kumar R, Nabi G. Post-cesarean cervicovesical fistula: technique of laparoscopic repair. J Urol. 2001;165:1167–8.
Abdel-Karim AM, Moussa A, Elsalmy S. Laparoendoscopic single-site surgery extravesical repair of vesicovaginal fistula: early experience. Urology. 2011;78:567–71. https://doi.org/10.1016/j.urology.2011.05.036.
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Cao, M., Zhang, J., Chen, Y. et al. Transvaginal repair of vesicouterine fistulae: our experience of three cases. Int Urogynecol J (2021). https://doi.org/10.1007/s00192-021-04973-x
- Patient positioning
- Vaginal repair
- Vesicouterine fistula