Preliminary experience with minimally invasive transvaginal single-port laparoscopic vesicovaginal fistula repair: report of 10 cases.

Abstract

Background and purpose: As a common complication following genitourinary trauma, the methods and approaches for repairing vesicovaginal fistulas (VVF) remain controversial. Minimally invasive techniques, such as laparoscopy, are gaining widespread attention. This study summarizes our surgical experiences and postoperative management regarding transvaginal single-port laparoscopic repair of vesicovaginal fistulas.

Patients and methods: We retrospectively analyzed the clinical data of 10 transvaginal single-port laparoscopic vesicovaginal fistula repairs performed in the Department of Urology at the Second Affiliated Hospital of Nanchang University from September 2022 to August 2023. All patients had complex vesicovaginal fistulas that had been treated poorly by multiple surgeries. This analysis included the causes of the fistulas, perioperative care, and efficacy. We recorded the operation time, intraoperative blood loss, and length of hospital stay, and we analyzed and summarized the surgical methods and treatment outcomes. Patients were followed up for 12 months post-surgery to assess urinary leakage and changes in their quality of life.

Results: Among the 10 patients, the average age was 58 ± 4.10 years. All surgeries were successfully completed. The average operation time was 96 ± 15 min, with an average postoperative hospital stay of 5.70 ± 0.64 days. The urethral catheter was removed after 2 weeks of follow-up, and no patients experienced complications such as bleeding, urinary leakage, or infection. One month post-operation, both the cystomelan infusion test and cystography indicated no presence of a fistula or residual fistula tract. Follow-up cystoscopy conducted 3 months after the surgery showed that the fistula had completely healed, demonstrating remarkable surgical outcomes. One year after the surgery, the patients were asymptomatic and showed no signs of recurrence.

Conclusion: Transvaginal single-port laparoscopic vesicovaginal fistula repair is safe and effective in treating complex vesicovaginal fistula, while retaining bladder function to the greatest extent, and is worthy of clinical promotion and application.