Abstract
Vesicovaginal fistulae have always been a highly problematic complication. Nowadays, most cases are complications after hysterectomy or obstetric surgery, whereas obstructed labour is the main aetiology in underdeveloped countries. The localisations and dimensions of the fistulae are very different dependent on their aetiology. Obstructed labour leads to necrosis of the anterior vaginal wall and consequently to a lower, urethrovaginal, vesicovaginal or combined fistula. After hysterectomy, we know that fistulae occur in about 1/1,800 cases. At a rate of 600,000 hysterectomies in the United States in 2003, we can assume approximately 330 fistulae had to be treated in that year. This makes it not only a social but also an economic issue. These fistulae are usually found to be supratrigonal and sometimes located high on the bladder dome. This fact makes it very demanding or even impossible to operate transvaginally. They occur after inadvertent lesion of the bladder or ureters, operation-site infection or tumourous diseases. The success rate of either repair is between 75 and 97 % depending on the method and complexity. Smaller fistulae can be treated by transurethral drainage and sometimes by transurethral coagulation of the bladder wall, depending on their aetiology. However, the long-term results are not very impressive (7–12.5 %). A valuable alternative to conservative treatment is the use of fibrin glue. In case of failure, the operative access is still available.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Miller EA, Webster GD (2001) Current management of vesicovaginal fistulae. Curr Opin Urol 11(4):417–421
Wu JM et al (2007) Hysterectomy rates in the United States, 2003. Obstet Gynecol 110(5):1091–1095
von Theobald P, Hamel P, Febbraro W (1998) Laparoscopic repair of a vesicovaginal fistula using an omental J flap. Br J Obstet Gynaecol 105(11):1216–1218
Eilber KS et al (2003) Ten-year experience with transvaginal vesicovaginal fistula repair using tissue interposition. J Urol 169(3):1033–1036
Ijaiya MA et al (2010) Vesicovaginal fistula: a review of nigerian experience. West Afr J Med 29(5):293–298
Hilton P, Ward A (1998) Epidemiological and surgical aspects of urogenital fistulae: a review of 25 years’ experience in southeast Nigeria. Int Urogynecol J Pelvic Floor Dysfunct 9(4):189–194
Hilton P (2001) Vesico-vaginal fistula: new perspectives. Curr Opin Obstet Gynecol 13(5):513–520
Kanaoka Y et al (2001) Vesicovaginal fistula treated with fibrin glue. Int J Gynaecol Obstet 73(2):147–149
Nagraj HK, Kishore TA, Nagalaksmi S (2007) Early laparoscopic repair for supratrigonal vesicovaginal fistula. Int Urogynecol J Pelvic Floor Dysfunct 18(7):759–762
Blaivas JG, Heritz DM, Romanzi LJ (1995) Early versus late repair of vesicovaginal fistulas: vaginal and abdominal approaches. J Urol 153(4):1110–1112; discussion 1112–1113
Raz S et al (1993) Transvaginal repair of vesicovaginal fistula using a peritoneal flap. J Urol 150(1):56–59
Kumar S, Kekre NS, Gopalakrishnan G (2007) Vesicovaginal fistula: an update. Indian J Urol 23(2):187–191
Lee RA, Symmonds RE, Williams TJ (1988) Current status of genitourinary fistula. Obstet Gynecol 72(3 Pt 1):313–319
Rizvi SJ et al (2010) Modified laparoscopic abdominal vesico-vaginal fistula repair–“Mini-O’Conor” vesicotomy. J Laparoendosc Adv Surg Tech A 20(1):13–15
Chibber PJ, Shah HN, Jain P (2005) Laparoscopic O’Conor’s repair for vesico-vaginal and vesico-uterine fistulae. BJU Int 96(1):183–186
Nezhat CH et al (1994) Laparoscopic repair of a vesicovaginal fistula: a case report. Obstet Gynecol 83(5 Pt 2):899–901
Wong C, Lam PN, Lucente VR (2006) Laparoscopic transabdominal transvesical vesicovaginal fistula repair. J Endourol 20(4):240–243; discussion 243
Sotelo R et al (2005) Laparoscopic repair of vesicovaginal fistula. J Urol 173(5):1615–1618
Tiong HY et al (2007) Laparoscopic repair of vesicovaginal fistula. Int Urol Nephrol 39(4):1085–1090
Otsuka RA et al (2008) Laparoscopic repair of vesicovaginal fistula. J Endourol 22(3):525–527
Porpiglia F et al (2009) Laparoscopic vesico-vaginal fistula repair: our experience and review of the literature. Surg Laparosc Endosc Percutan Tech 19(5):410–414
Ou CS et al (2004) Laparoscopic repair of vesicovaginal fistula. J Laparoendosc Adv Surg Tech A 14(1):17–21
Abdel-Karim AM et al (2011) Laparoscopic transperitoneal extravesical repair of vesicovaginal fistula. Int Urogynecol J Pelvic Floor Dysfunct 22(6):693–697
Gozen AS et al (2009) Transperitoneal laparoscopic repair of iatrogenic vesicovaginal fistulas: Heilbronn experience and review of the literature. J Endourol 23(3):475–479
Erdogru T et al (2008) Laparoscopic transvesical repair of recurrent vesicovaginal fistula using with fleece-bound sealing system. Arch Gynecol Obstet 277(5):461–464
Miklos JR, Sobolewski C, Lucente V (1999) Laparoscopic management of recurrent vesicovaginal fistula. Int Urogynecol J Pelvic Floor Dysfunct 10(2):116–117
Hemal AK, Kumar R, Nabi G (2001) Post-cesarean cervicovesical fistula: technique of laparoscopic repair. J Urol 165(4):1167–1168
Melamud O et al (2005) Laparoscopic vesicovaginal fistula repair with robotic reconstruction. Urology 65(1):163–166
Sundaram BM, Kalidasan G, Hemal AK (2006) Robotic repair of vesicovaginal fistula: case series of five patients. Urology 67(5):970–973
Hemal AK, Kolla SB, Wadhwa P (2008) Robotic reconstruction for recurrent supratrigonal vesicovaginal fistulas. J Urol 180(3):981–985
Schimpf MO et al (2007) Vesicovaginal fistula repair without intentional cystotomy using the laparoscopic robotic approach: a case report. JSLS 11(3):378–380
Engel N, John H (2008) Laparoscopic robot assisted vesico-vaginal fistula repair with peritoneal flap inlay. J Urol 179(suppl 4):666
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2013 Springer-Verlag Berlin Heidelberg
About this chapter
Cite this chapter
Kurz, M., John, H. (2013). Robot-Assisted Laparoscopic Repair of Supratrigonal Vesicovaginal Fistulae with Peritoneal Flap Inlay. In: John, H., Wiklund, P. (eds) Robotic Urology. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-33215-9_34
Download citation
DOI: https://doi.org/10.1007/978-3-642-33215-9_34
Published:
Publisher Name: Springer, Berlin, Heidelberg
Print ISBN: 978-3-642-33214-2
Online ISBN: 978-3-642-33215-9
eBook Packages: MedicineMedicine (R0)