VAGINAL REPAIR OF RECURRENT VESICO-VAGINAL FISTULA

 

M. Karram, S. Kleeman

University of Cincinnati, Good Samaritan Hospital, Cincinnati. OH

 

OBJECTIVE:  Demonstrate techniques in a transvaginal operation for repair of a recurrent vesico-vaginal fistula.

MATERIALS AND METHODS: The case shows a patient who developed a vesico-vaginal fistula after a laparoscopic assisted vaginal hysterectomy performed for endometriosis.  A Latzko procedure was performed which failed in the immediate postoperative period.  This is a second repair.

RESULTS:  The video demonstrates identification of two fistulae, wide mobilization of the fistula, multi-layer closure, and omentum used to cover the repair.

CONCLUSIONS:  The recommended principles of fistula repair are demonstrated producing a good repair of this recurrent fistula.

 

Key Words: vesicovaginal fistula, Latzko procedure  

 

Disclosure – Speakers Bureau: M. Karram, Ortho-McNeil, Gynecare, Indevis, Watson; S. Kleeman, Pfizer. Consultant: M. Karram, Gynecare; S. Kleeman, Mentor, AMS, Boston Scientific.