Analysis of the efficacy of modified laparoscopic ureterobladder reimplantation in the treatment of ureterovaginal fistula.

Abstract

Objective: Analysis of technical improvements and efficacy of modified laparoscopic ureteral bladder reimplantation for the treatment of ureterovaginal fistula.

Methods: A retrospective analysis was conducted on clinical data from 20 patients who developed a ureterovaginal fistula due to gynecological surgeries and underwent modified laparoscopic ureteral bladder reimplantation at our hospital from September 2018 to May 2024.

Results: 20 patients with ureterovaginal fistula were included, with 9 cases on the left side, 9 on the right side, and 2 bilateral. The locations of the ureterovaginal fistulas were all in the distal ureter. The average age was 50.24 ± 5.22 years, and the average body mass index was 23.22 ± 3.98. The average duration of urine leakage before surgery was 12.20 ± 7.05 days. All surgeries were successful (20/20), with an average operation time of 140.85 ± 55.80 min, intraoperative blood loss of 14.50 ± 7.42 ml, and postoperative hospital stay of 8.24 ± 4.47 days. The ureteral stents were left in place for a mean duration of (51.50 ± 9.65) days postoperatively. No complications occurred after the surgery, and imaging follow-up at 9 months indicated that all patients had recovered well.

Conclusion: Early diagnosis and treatment are essential for patients with ureterovaginal fistula. During the modified ureteral bladder reimplantation, it is crucial to ensure tension-free anastomosis without excessive dissection of the distal ureter. Laparoscopic ureteral bladder reimplantation is a reliable, safe, minimally invasive, and well-accepted surgical method, deserving of further promotion.