Post hysterectomy vesicovaginal fistula repair without vaginal vault closure - A simple laparoscopic extravesical repair approach

IF 0.8 Q4 UROLOGY & NEPHROLOGY
S. Swain, S. Rulaniya, V. Neniwal, Pamelle Yadav, P. Agarwal, Shweta Bhalothia, K. Tonge, Zaid Khan
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引用次数: 0

Abstract

Purpose: The purpose of this study is to describe a simple extravesical laparoscopic approach for supratrigonal vesicovaginal fistula (VVF) repair without cystotomy and closer of the vaginal vault. Materials and Methods: This retrospective observational study reviewed data of 36 patients from January 2015 to January 2020. In our technique, the fistula tract was identified without cystotomy with the help of preplaced ureteric catheter in VVF tract. After meticulous extravesical dissection of the fistula tract, the bladder wall was closed in a single layer using polyglactin 2.0 sutures. The omental flap was approximated over the vaginal vault without primary closer of the vault. Results: In most of the patients the fistula opening were located 2 cm away from ureteric orifice while in 4 patients it located within 2 cm of orifice. The mean operative time was 86 min (65–125) and estimated blood loss was 94 ml (40–130). The mean size of fistula was 7.1 mm (5–15 mm). Omental flap was approximate over vaginal opening in most of the patients. The average hospital stay of patients was 5 days. In all patients, Foley catheter was removed on day 14 after cystogram. The mean follow-up of patients was 4.2 months (3–7). All patients remained continent and symptom free during the follow-up periods. Conclusion: Our technique without suturing of the vaginal vault in laparoscopic VVF repair is safe in a simple supratrigonal fistula with good results and avoiding added suturing.
子宫切除术后膀胱阴道瘘修补术无阴道拱顶封闭-一种简单的腹腔镜膀胱外修补方法
目的:本研究的目的是描述一种简单的膀胱外腹腔镜方法,用于三角上膀胱阴道瘘(VVF)修复,无需膀胱切开术和阴道拱顶闭合术。材料和方法:这项回顾性观察性研究回顾了2015年1月至2020年1月期间36名患者的数据。在我们的技术中,在VVF道中预先放置的输尿管导管的帮助下,在没有膀胱切开的情况下识别瘘道。在对瘘管进行细致的膀胱外剥离后,使用聚肌动蛋白2.0缝线将膀胱壁封闭在单层中。网膜瓣接近阴道穹窿,没有初级穹窿闭合器。结果:大多数患者的瘘口位于离输尿管口2cm的位置,而4例患者瘘口位于距输尿管口2cm以内。平均手术时间为86分钟(65-125),估计失血量为94毫升(40-130)。瘘管的平均大小为7.1毫米(5-15毫米)。在大多数患者中,网膜瓣接近阴道开口。患者的平均住院时间为5天。在所有患者中,在膀胱造影术后第14天取出Foley导管。患者的平均随访时间为4.2个月(3-7个月)。所有患者在随访期间均保持无症状。结论:在腹腔镜VVF修补术中,我们的阴道拱顶不缝合技术对简单的三角上瘘是安全的,效果良好,避免了额外的缝合。
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来源期刊
Urological Science
Urological Science UROLOGY & NEPHROLOGY-
CiteScore
1.20
自引率
0.00%
发文量
26
审稿时长
6 weeks
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