Gonzalez LT, Suárez MME, Tegegne A, Cacho NME, Vela CI, Frigola J

Language: Spanish
References: 25
Page:
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ABSTRACT

Introduction: Among the lesions of the urinary tract caused by iatrogenic surgery, vesicovaginal fistula is the most frequent, mainly due to abdominal hysterectomy.
Objective: To show the perioperative results and success of laparoscopic surgery for vesicovaginal fistula.
Methods: A prospective series of 30 patients operated by laparoscopic approach at the National Center for Minimally Invasive Surgery between January 2006 and June 2015 that fulfilled inclusion criteria: clinical diagnosis of supratrigonal vesicovaginal fistula of retrotrigonal location; over 18 years of age; with a progress of at least three months of a primary fistula or with one previous attempt of repair; patients that gave their consent to participate in the research. A transvesical transperitoneal laparoscopic approach was performed, resection of the fistula and closure of the vagina and bladder in continuous single layer. Ureteral and urethral catheter and peritoneal drainage were also used.
Results: Average age was 46.3 years. Most patients had only one primary fistula of surgical cause. No conversion to open surgery was required. The result was successful in 28 patients (93.3 %); there were complications in two of them.
Conclusions: Laparoscopic approach for VVF is feasible, with a high success rate and safety; it is a minimally invasive therapeutic alternative that should be considered in our line of work.

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