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Current Urology Reports

, Volume 14, Issue 3, pp 253–261 | Cite as

Advances in Minimally Invasive Repair of Vesicovaginal Fistulas

  • Christopher F. Tenggardjaja
  • Howard B. Goldman
Female Urology (H Goldman, Section Editor)

Abstract

Over the past 20 years, the discussion concerning vesicovaginal fistula (VVF) repair has evolved from strictly transabdominal/transvaginal to including minimally invasive surgeries. The original natural orifice approach through the vagina allows for VVF repair with decreased morbidity and minimal convalescence with success rates upwards of 90 %. For surgeries that involve a narrowed/stenotic vagina or a need for a concomitant abdominal procedure, transadominal surgery can be performed by laparoscopic or robot-assisted laparoscopic approaches. Success rates in large series are upwards of 86 %. Difficulties such as an increased learning curve and vesicovaginal plane dissection have been overcome with innovations such as the robotic platform and cutting to the light with vaginoscopy. While still in its infancy in VVF repair, single site surgery has also been utilized with reasonable success. Although minimally invasive surgery offers numerous advantages, the most successful approach will still be the surgery with which the VVF surgeon is most familiar.

Keywords

Female urogenital diseases Vesicovaginal fistula Laparoscopy/methods Minimally invasive surgical procedures Robotic/methods Urologic surgical procedures/methods Gynecologic surgical procedures/methods 

Notes

Disclosure

Dr. Christopher F. Tenggardjaja reported no potential conflicts of interest relevant to this article.

Dr. Howard B. Goldman is a section editor for Current Urology Reports. Dr. Goldman received consultancies from Allergan, Medtronic, and Teva. Dr. Goldman received payments for lectures from Astellas, Allergan, and Medtronic.

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Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Christopher F. Tenggardjaja
    • 1
  • Howard B. Goldman
    • 1
  1. 1.Center for Female Pelvic Medicine and Reconstructive SurgeryCleveland Clinic Glickman Urologic and Kidney InstituteClevelandUSA

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