Laparoscopic repair of the vesicovaginal fistula (laparoscopic O'Connor repair).
BACKGROUND
The most frequent cause of vesicovaginal fistula in developed countries is hysterectomy, while in the third world it is related to time in labour. Any surgical iatrogenic trauma implies encountering added difficulties of various kinds when repairing the condition.


METHODS
We report the first case of vesicovaginal fistula to be resolved laparoscopically in our department. The patient is a woman 50 years of age who had undergone an abdominal hysterectomy 8 months previously, and who presented a syndrome compatible with vesicovaginal fistula. She was referred to our division after an unsuccessful attempt at vaginal repair. We will now describe the laparoscopic vesicovaginal fistula repair procedure.


RESULTS
The surgical procedure lasted approximately 3 hours and 30 minutes. The patient began oral intake 48 hours after surgery, normal intestinal transit was restored by the 5th day, a cystography was performed on the 7th day, and the patient was discharged on the 8th day. The patient remains asymptomatic after more than a year and a half.


CONCLUSIONS
Laparoscopic resolution of vesicovaginal fistula is perfectly feasible and safe. If we consistently reproduce the principles applied in the open surgery, it offers the same success rate with the lowest possible morbidity.
Alonso y Gregorio
Sergio
S
Urology Department. La Paz Hospital, Madrid, Spain. GARAVELOS@terra.es
Alvarez Maestro
Mario
M
Cabrera Castillo
Pedro M
PM
Hidalgo Togores
Luis
L
de la Peña Barthel
J Javier
JJ
D005260:Female; D006801:Humans; D010535:Laparoscopy; D008875:Middle Aged; D013520:Urologic Surgical Procedures / Q000379:methods; D014719:Vesicovaginal Fistula / Q000601:surgery*