Laparoscopic repair of iatrogenic vesicovaginal and rectovaginal fistula.
OBJECTIVE
To investigate the clinical efficacy of laparoscopic repair of iatrogenic vesicovaginal fistulas (VVF) and rectovaginal fistulas.


METHODS
Seventeen female patients with iatrogenic fistulas (11 cases of VVF and 6 cases of high rectovaginal fistulas) were included. All patients were hospitalized and underwent laparoscopic fistula repair in our hospital between 2008 and 2012. The mean age of the patients was 44.8 ± 9.1 years. The fistulas and scar tissue were completely excised by laparoscopy, orifices were tension-free closed using absorbable sutures, omental flaps were interposed between the vagina and the bladder or rectum, and drainage was kept after repair.


RESULTS
Laparoscopic repair of fistulas was successful in all 17 patients. No complication was found during or after repair. No reoperation was needed after the repair. The operative time was 80.2 ± 30.0 minutes (range 50-140 minutes). The blood loss was 229.4 ± 101.6 ml (range 100-400 ml). The double J catheters were placed in 7 patients and removed 1-2 months after repair. Eight VVF patients underwent cystoscopy 3 months after laparoscopic repair and there were no abnormal findings. The follow-up time was 17.1 ± 6.5 months (range 8-29 months).


CONCLUSIONS
Laparoscopic repair of VVF and rectovaginal fistulas is a safe and an effective minimally invasive procedure for treatment of iatrogenic fistula.
Department of Obstetrics and Gynecology, Tongji Hospital of Tongji University Shanghai 200065, China.
Lei
L
Chu
Department of Obstetrics and Gynecology, Tongji Hospital of Tongji University Shanghai 200065, China.
Jian-Jun
JJ
Wang
Department of Obstetrics and Gynecology, Tongji Hospital of Tongji University Shanghai 200065, China.
Li
L
Li
Department of Obstetrics and Gynecology, Tongji Hospital of Tongji University Shanghai 200065, China.
Xiao-Wen
XW
Tong
Department of Obstetrics and Gynecology, Tongji Hospital of Tongji University Shanghai 200065, China.
Bo-Zhen
BZ
Fan
Department of Obstetrics and Gynecology, Tongji Hospital of Tongji University Shanghai 200065, China.
Yi
Y
Guo
Department of Obstetrics and Gynecology, Tongji Hospital of Tongji University Shanghai 200065, China.
Huai-Fang
HF
Li
Laparoscopy; extravesical repair; rectovaginal fistula; vesicovaginal fistula