Abstract
Vesicovaginal fistula (VVF) is a distressing condition that affects 0.3–2% of women worldwide, with developing countries representing most of the cases. Transabdominal techniques in VVF repairs have evolved and now include minimally invasive approaches. Different minimally invasive surgical techniques have been described based on the way that the fistulous tract is approached (retrovesical, transvesical, and transvaginal). The traditional transvesical approach consists in an intentional cystotomy that is extended toward the fistulous tract. The plane between the bladder and the vagina is subsequently dissected, and both organs are closed separately. Finally, a previously harvested omentum flap is interposed and fixed in place. Several complications have been described such as acute urinary retention, vaginal bleeding, hematuria, ureteric injury, cervical canal injury, or fistula recurrence. While the use of robotic surgery in VVF repairs is still in its infancy, this approach is especially useful in the setting of complex cases.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Eilber KS, Kavaler E, Rodriguez LV, Rosenblum N, Raz S. Ten-year experience with transvaginal vesicovaginal fistula repair using tissue interposition. J Urol. 2003;169(3):1033–6.
Bragayrac LAHD, Sotelo RJ. Urinary fistulas. In: Sotelo RAM, Arriaga J, editors. Complications in robotic urologic surgery. Cham: Springer; 2018. p. 285–97.
Moses RA, Ann Gormley E. State of the art for treatment of vesicovaginal fistula. Curr Urol Rep. 2017;18(8):60.
Roth R. Vesicovaginal and urethrovaginal fistulas. In: Howard Jones JR, editor. Te-Linde’s operative gynecology. Philadelphia: JB Lippincott; 2011. p. 973–93.
JM S. On the treatment of vesicovaginal fistula. Am J Med Sci. 1852;23:50.
Nezhat CH, Nezhat F, Nezhat C, Rottenberg H. Laparoscopic repair of a vesicovaginal fistula: a case report. Obstet Gynecol. 1994;83(5 Pt 2):899–901.
Bragayrac LA, Azhar RA, Fernandez G, Cabrera M, Saenz E, Machuca V, et al. Robotic repair of vesicovaginal fistulae with the transperitoneal-transvaginal approach: a case series. Int Braz J Urol. 2014;40(6):810–5.
Medina LG, Hernandez A, Sevilla C, Cacciamani GE, Winter M, Ashrafi A, et al. Robotic uterine-sparing vesicovaginal fistula repair. Int Urogynecol J. 2018;29(12):1845–7.
Ramphal SR. Laparoscopic approach to vesicovaginal fistulae. Best Pract Res Clin Obstet Gynaecol. 2018;54:49–60.
Nagraj HK, Kishore TA, Nagalaksmi S. Early laparoscopic repair for supratrigonal vesicovaginal fistula. Int Urogynecol J Pelvic Floor Dysfunct. 2007;18(7):759–62.
Melamud O, Eichel L, Turbow B, Shanberg A. Laparoscopic vesicovaginal fistula repair with robotic reconstruction. Urology. 2005;65(1):163–6.
Sanchez AML, Husain F, Sotelo R. Complications of robotic surgical access. In: Hubert JWP, editor. Robotic urology. 3th ed. Stockholm: Springer; 2018. p. 517–28.
Paparel P, Caillot JL, Perrin P, Ruffion A. Surgical principles of omentoplasty in urology. BJU Int. 2007;99(5):1191–6.
Sotelo R, Moros V, Clavijo R, Poulakis V. Robotic repair of vesicovaginal fistula (VVF). BJU Int. 2012;109(9):1416–34.
Bodner-Adler B, Hanzal E, Pablik E, Koelbl H, Bodner K. Management of vesicovaginal fistulas (VVFs) in women following benign gynaecologic surgery: a systematic review and meta-analysis. PLoS One. 2017;12(2):e0171554.
Barski D, Gerullis H, Ecke T, Varga G, Boros M, Pintelon I, et al. Repair of a vesico-vaginal fistula with amniotic membrane – step 1 of the IDEAL recommendations of surgical innovation. Cent European J Urol. 2015;68(4):459–61.
Price DT, Price TC. Robotic repair of a vesicovaginal fistula in an irradiated field using a dehydrated amniotic allograft as an interposition patch. J Robot Surg. 2016;10(1):77–80.
Daley SMLC, Swanson SK, Novicki DE, Itano NB. Fibrin sealant closure of a persistent vesicovaginal fistula after failed transabdominal closure. J Pelvic Med Surg. 2006;12(4):229–30.
Sawant AS, Kasat GV, Kumar V. Cyanoacrylate injection in management of recurrent vesicovaginal fistula: our experience. Indian J Urol. 2016;32(4):323–5.
Angioli R, Penalver M, Muzii L, Mendez L, Mirhashemi R, Bellati F, et al. Guidelines of how to manage vesicovaginal fistula. Crit Rev Oncol Hematol. 2003;48(3):295–304.
Cromwell D, Hilton P. Retrospective cohort study on patterns of care and outcomes of surgical treatment for lower urinary-genital tract fistula among English National Health Service hospitals between 2000 and 2009. BJU Int. 2013;111(4 Pt B):E257–62.
Bora GS, Singh S, Mavuduru RS, Devana SK, Kumar S, Mete UK, et al. Robot-assisted vesicovaginal fistula repair: a safe and feasible technique. Int Urogynecol J. 2017;28(6):957–62.
Gupta NP, Mishra S, Hemal AK, Mishra A, Seth A, Dogra PN. Comparative analysis of outcome between open and robotic surgical repair of recurrent supra-trigonal vesico-vaginal fistula. J Endourol. 2010;24(11):1779–82.
Medina LG, Cacciamani GE, Hernandez A, Landsberger H, Doumanian L, Ashrafi AN, et al. Robotic management of rectourethral fistulas after focal treatment for prostate cancer. Urology. 2018;118:241.
Sotelo R, Medina LG, Husain FZ, Khazaeli M, Nikkhou K, Cacciamani GE, et al. Robotic-assisted laparoscopic repair of rectovesical fistula after Hartmann’s reversal procedure. J Robot Surg. 2018;339–43.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Electronic Supplementary Material
Robotic vesicovaginal fistula repair
Rights and permissions
Copyright information
© 2022 Springer Nature Switzerland AG
About this chapter
Cite this chapter
Medina, L.G., Han, J., Sotelo, R. (2022). Robotic Management of Vesicovaginal Fistulas. In: Stifelman, M.D., Zhao, L.C., Eun, D.D., Koh, C.J. (eds) Techniques of Robotic Urinary Tract Reconstruction. Springer, Cham. https://doi.org/10.1007/978-3-030-50196-9_30
Download citation
DOI: https://doi.org/10.1007/978-3-030-50196-9_30
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-030-50195-2
Online ISBN: 978-3-030-50196-9
eBook Packages: MedicineMedicine (R0)