Laparoscopic vesicovaginal fistula repair: Our initial experience.

Introduction: Vesicovaginal fistula (VVF) is well recognized complication of prolonged labor or urogynecologic surgery. Failing conservative management, it may be repaired with abdominal or vaginal approach. We herein share our initial experience of VVF repair done laparoscopically through transperitoneal approach. Materials and Methods: From January 2005 to January 2007, we treated 4 cases of VVF developed following vaginal hysterectomy. All except one had fistula recognized in post operative period. In one case, bladder injury was recognized intraoperative, repaired primarily but developed VVF immediately after removal of urethral catheter. All cases underwent successful laparoscopic VVF repair (O'Conor's) by standard transperitoneal approach. Results: The mean operative time was 176 minutes. The estimated blood loss was 40 cc. The mean hospital stay was 2.7 days. The urethral catheter was removed at 2 weeks after visualizing no extravasation on cystogram. In follow up, all patients are asymptomatic with normal voiding. Conclusion: Laparoscopic VVF repair is feasible and efficacious approach for VVF repair. [ABSTRACT FROM AUTHOR]