Minimal Access, Optimal Dryness: A Review of Laparoscopic Repair of Vesicovaginal Fistula

Abstract

Background: Vesicovaginal fistula (VVF) is a an embarrassing condition to women . Various routes of surgical intervention exists with regards to the management of VVF. Laparoscopic repair has been shown to be safe and effective. Objective: To review the success rate of laparoscopic repair of VVF and to highlight the benefits/advantages of the laparoscopic approach. Methods: Using various databases, previous studies of patients who underwent laparoscopic VVF repair between 2008 and 2018 were reviewed . Outcome measures from these studies were success rate, mean blood loss, mean operating time, length of hospital stay, major intraoperative complications and conversion to open surgery. Results: 14 retrospective studies (full text articles) were retrieved and reviewed. 269 patients had laparoscopic repair . The pooled success rate was 96.7%.. Mean Blood loss ranged from 30400mls, length of hospital stay ranged from 1.1 to 7.8 days while the mean operating time ranged from 54 to 229 minutes. There was only one major intra operative complication . Only 4 patients had to be converted to open surgery. Conclusion: Laparoscopic repair of VVF has a high success rate and is a safe, patient friendly and cost effective route for surgical management of VVF.