title: Laparoscopic repair of urogenital fistulae: A single centre experience.
abstract: BACKGROUND
  Sparse literature exists on laparoscopic repair of urogenital fistulae (UGF).
  
  
  OBJECTIVE
  The purpose of the following study is to report our experience of laparoscopic UGF repair with emphasis on important steps for a successful laparoscopic repair.
  
  
  METHODS
  Data of patients who underwent laparoscopic repair of UGF from 2003 to 2012 was retrospectively reviewed.
  
  
  METHODS
  Data was reviewed as to the aetiology, prior failed attempts, size, number and location of fistula, mean operative time, blood loss, post-operative storage/voiding symptoms and episodes of urinary tract infections (UTI).
  
  
  RESULTS
  Laparoscopic repair of 22 supratrigonal vesicovaginal fistulae (VVF) (five recurrent) and 31 ureterovaginal fistulae (UVF) was performed. VVF followed transabdominal hysterectomy (14), lower segment caesarean section (LSCS) (7) and oophrectomy (1). UVF followed laparoscopy assisted vaginal hysterectomy (18), transvaginal hysterectomy (2) and transabdominal hysterectomy (10) and LSCS (1). Mean VVF size was 14 mm. Mean operative time and blood loss for VVF and UVF were 140 min, 75 ml and 130 min, 60 ml respectively. In 20 VVF repairs tissue was interposed between non-overlapping suture lines. Vesico-psoas hitch was done in 29 patients of urterovaginal fistulae. All patients were continent following surgery. There were no urinary complaints in VVF patients and no UTI in UVF patients over a median follow-up of 3.2 years and 2.8 years respectively.
  
  
  CONCLUSIONS
  Laparoscopic repair of UGF gives easy, quick access to the pelvic cavity. Interposition of tissue during VVF repair and vesico-psoas hitch during UVF repair form important steps to ensure successful repair.
authors.affiliation: Department of Urology and Renal Transplantation, IKDRC-ITS, Asarwa, Ahmedabad, Gujarat, India.
authors.forename: Sumit
authors.initials: S
authors.lastname: Sharma
authors.affiliation: Department of Urology and Renal Transplantation, IKDRC-ITS, Asarwa, Ahmedabad, Gujarat, India.
authors.forename: Syed Jamal
authors.initials: SJ
authors.lastname: Rizvi
authors.affiliation: Department of Urology and Renal Transplantation, IKDRC-ITS, Asarwa, Ahmedabad, Gujarat, India.
authors.forename: Santhosh Shivanandaiah
authors.initials: SS
authors.lastname: Bethur
authors.affiliation: Department of Urology and Renal Transplantation, IKDRC-ITS, Asarwa, Ahmedabad, Gujarat, India.
authors.forename: Jyoti
authors.initials: J
authors.lastname: Bansal
authors.affiliation: Department of Urology and Renal Transplantation, IKDRC-ITS, Asarwa, Ahmedabad, Gujarat, India.
authors.forename: Syed Javid Farooq
authors.initials: SJ
authors.lastname: Qadri
authors.affiliation: Department of Urology and Renal Transplantation, IKDRC-ITS, Asarwa, Ahmedabad, Gujarat, India.
authors.forename: Pranjal
authors.initials: P
authors.lastname: Modi
keywords: Laparoscopy; O'Connor; ureteroneocystotomy; ureterovaginal fistula; urogenital fistula; vesico-psoas hitch; vesicovaginal fistula