Laparoscopic Treatment of Vesicovaginal Fistula
Introduction Vesicovaginal fistula is a rare disease with great impact for the patients. Laparoscopic repair can be an interesting option in selected cases with goods results but few experience is reported.Objectives Detailed demonstration of our laparoscopic vesicovaginal fistula repair technique....
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Sociedade Brasileira de Urologia
2014-06-01
|
| Series: | International Brazilian Journal of Urology |
| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1677-55382014000300435&lng=en&tlng=en |
| _version_ | 1819126678174040064 |
|---|---|
| author | Marcos Tobias-Machado Pablo Aloisio Lima Mattos Pedro Romanelli de Castro Ricardo Hissashi Nishimoto Antonio Carlos Lima Pompeo |
| author_facet | Marcos Tobias-Machado Pablo Aloisio Lima Mattos Pedro Romanelli de Castro Ricardo Hissashi Nishimoto Antonio Carlos Lima Pompeo |
| author_sort | Marcos Tobias-Machado |
| collection | DOAJ |
| description | Introduction Vesicovaginal fistula is a rare disease with great impact for the patients. Laparoscopic repair can be an interesting option in selected cases with goods results but few experience is reported.Objectives Detailed demonstration of our laparoscopic vesicovaginal fistula repair technique. Initial results for ten patients are provided Methods: We treated all cases by the same technique. The surgical steps were: Patient positioning in Lloyd-Davis; Cystoscopy and implant of guide wire on fistula and ureteral catheters (that was removed after procedure); Transperitoneal access and 4 or 5 ports in V or W shape; Opening the bladder wall; Dissection between bladder and vagina for tension free repair; Fistula resection; Vagina repair with Vicryl 3-0; Bladder repair with Vicryl 3-0; Peritoneum/omentum interposition; Positioning 20 Fr urethral catheter.Results Mean age was 50 years. Mean number of fistulas was 1,2. The most common etiology was gynecologic surgery (7). Mean operative time was 2,5 (1,8-3,2) hours. Mean blood loss was 150 (100-200)mL. Complication rate was 10% (one case of urinary infection treated conservatively). Mean hospital stay was 1,2 (1-2) days. Mean return to normal and activities was 20 (15-30) days. For nine patients mean sexual intercourse time was 3 (1-6) months. Success rate after 1 year was 90% (one case of recurrence in patient with previous radiotherapy). Mean follow-up was 36 (12-60) months.Conclusions Laparoscopic repair is feasible, reproducible and present all advantages of minimally invasive surgical procedure. Long term results are similar to conventional open approaches. |
| first_indexed | 2024-12-22T07:59:51Z |
| format | Article |
| id | doaj.art-43921c6eabb94fcaa495f75f6e42d609 |
| institution | Directory Open Access Journal |
| issn | 1677-6119 |
| language | English |
| last_indexed | 2024-12-22T07:59:51Z |
| publishDate | 2014-06-01 |
| publisher | Sociedade Brasileira de Urologia |
| record_format | Article |
| series | International Brazilian Journal of Urology |
| spelling | doaj.art-43921c6eabb94fcaa495f75f6e42d6092022-12-21T18:33:17ZengSociedade Brasileira de UrologiaInternational Brazilian Journal of Urology1677-61192014-06-0140343543610.1590/S1677-5538.IBJU.2014.03.23S1677-55382014000300435Laparoscopic Treatment of Vesicovaginal FistulaMarcos Tobias-MachadoPablo Aloisio Lima MattosPedro Romanelli de CastroRicardo Hissashi NishimotoAntonio Carlos Lima PompeoIntroduction Vesicovaginal fistula is a rare disease with great impact for the patients. Laparoscopic repair can be an interesting option in selected cases with goods results but few experience is reported.Objectives Detailed demonstration of our laparoscopic vesicovaginal fistula repair technique. Initial results for ten patients are provided Methods: We treated all cases by the same technique. The surgical steps were: Patient positioning in Lloyd-Davis; Cystoscopy and implant of guide wire on fistula and ureteral catheters (that was removed after procedure); Transperitoneal access and 4 or 5 ports in V or W shape; Opening the bladder wall; Dissection between bladder and vagina for tension free repair; Fistula resection; Vagina repair with Vicryl 3-0; Bladder repair with Vicryl 3-0; Peritoneum/omentum interposition; Positioning 20 Fr urethral catheter.Results Mean age was 50 years. Mean number of fistulas was 1,2. The most common etiology was gynecologic surgery (7). Mean operative time was 2,5 (1,8-3,2) hours. Mean blood loss was 150 (100-200)mL. Complication rate was 10% (one case of urinary infection treated conservatively). Mean hospital stay was 1,2 (1-2) days. Mean return to normal and activities was 20 (15-30) days. For nine patients mean sexual intercourse time was 3 (1-6) months. Success rate after 1 year was 90% (one case of recurrence in patient with previous radiotherapy). Mean follow-up was 36 (12-60) months.Conclusions Laparoscopic repair is feasible, reproducible and present all advantages of minimally invasive surgical procedure. Long term results are similar to conventional open approaches.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1677-55382014000300435&lng=en&tlng=en |
| spellingShingle | Marcos Tobias-Machado Pablo Aloisio Lima Mattos Pedro Romanelli de Castro Ricardo Hissashi Nishimoto Antonio Carlos Lima Pompeo Laparoscopic Treatment of Vesicovaginal Fistula International Brazilian Journal of Urology |
| title | Laparoscopic Treatment of Vesicovaginal Fistula |
| title_full | Laparoscopic Treatment of Vesicovaginal Fistula |
| title_fullStr | Laparoscopic Treatment of Vesicovaginal Fistula |
| title_full_unstemmed | Laparoscopic Treatment of Vesicovaginal Fistula |
| title_short | Laparoscopic Treatment of Vesicovaginal Fistula |
| title_sort | laparoscopic treatment of vesicovaginal fistula |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1677-55382014000300435&lng=en&tlng=en |
| work_keys_str_mv | AT marcostobiasmachado laparoscopictreatmentofvesicovaginalfistula AT pabloaloisiolimamattos laparoscopictreatmentofvesicovaginalfistula AT pedroromanellidecastro laparoscopictreatmentofvesicovaginalfistula AT ricardohissashinishimoto laparoscopictreatmentofvesicovaginalfistula AT antoniocarloslimapompeo laparoscopictreatmentofvesicovaginalfistula |