Simple and effective: transvaginal vesico-vaginal fistula repair with a modified Latzko technique.

Olivia Cardenas-Trowers, John Heusinkveld, Kenneth Hatch
Author Information
  1. Olivia Cardenas-Trowers: Department of Obstetrics and Gynecology, University of Arizona, 1501 North Campbell Avenue, PO Box 245078, Tucson, AZ, 85724, USA. ocardenastrowers@obgyn.arizona.edu. ORCID
  2. John Heusinkveld: Department of Obstetrics and Gynecology, University of Arizona, 1501 North Campbell Avenue, PO Box 245078, Tucson, AZ, 85724, USA.
  3. Kenneth Hatch: Department of Obstetrics and Gynecology, University of Arizona, 1501 North Campbell Avenue, PO Box 245078, Tucson, AZ, 85724, USA.

Abstract

INTRODUCTION AND HYPOTHESIS: The incidence of vesico-vaginal fistulas after hysterectomies for benign indications in developed countries is less than one percent. The objective of this video is to demonstrate an easy-to-follow, step-by-step approach to repairing a small, uncomplicated vesico-vaginal fistula transvaginally using a modified Latzko technique.
METHODS: In this video, we present a case of a 46-year-old woman who developed a simple, uncomplicated vesico-vaginal fistula after a total abdominal hysterectomy. To correct her fistula, we used a modified Latzko technique, which is a transvaginal approach to vesico-vaginal fistula repair that involves mobilizing the vaginal mucosa around the fistula and then closing the pubo-vesical fascia and vaginal mucosa in layers.
RESULTS: The patient had successful surgical correction of her vesico-vaginal fistula without recurrence of the fistula.
CONCLUSIONS: For small, uncomplicated vesico-vaginal fistulas, a transvaginal approach has an equivalent success rate to that of other approaches with less invasiveness and faster recovery times. Therefore, it is reasonable to use a modified Latzko technique to help restore the quality of life to women affected by small, uncomplicated vesico-vaginal fistulas.

Keywords

References

  1. Obstet Gynecol. 1998 Jul;92(1):113-8 [PMID: 9649105]
  2. Int J Gynaecol Obstet. 1994 Apr;45(1):11-6 [PMID: 7913052]
  3. Female Pelvic Med Reconstr Surg. 2014 Jan-Feb;20(1):7-13 [PMID: 24368481]
  4. J Pak Med Assoc. 2015 Sep;65(9):954-9 [PMID: 26338740]
  5. Int Urogynecol J. 2016 Jun;27(6):831-7 [PMID: 26744338]
  6. Eur Urol. 2016 Sep;70(3):478-92 [PMID: 26922407]
  7. Urol J. 2015 Dec 23;12(6):2422-7 [PMID: 26706739]
  8. Int Urogynecol J Pelvic Floor Dysfunct. 2007 Mar;18(3):329-33 [PMID: 17036168]
  9. Arab J Urol. 2014 Jun;12(2):97-105 [PMID: 26019933]
  10. Crit Rev Oncol Hematol. 2003 Dec;48(3):295-304 [PMID: 14693342]
  11. Int J Urol. 2006 Apr;13(4):345-9 [PMID: 16734848]
  12. BJOG. 2012 Nov;119(12):1447-54 [PMID: 22901248]
  13. Urol Clin North Am. 1985 May;12(2):361-7 [PMID: 3887719]
  14. Am J Obstet Gynecol. 2013 Feb;208(2):112.e1-11 [PMID: 23201329]

MeSH Term

Child
Female
Gynecologic Surgical Procedures
Humans
Hysterectomy
Middle Aged
Quality of Life
Suture Techniques
Vesicovaginal Fistula

Word Cloud

Created with Highcharts 10.0.0fistulavesico-vaginalLatzkotechniqueuncomplicatedmodifiedfistulasapproachsmalltransvaginaldevelopedlessvideorepairvaginalmucosaINTRODUCTIONANDHYPOTHESIS:incidencehysterectomiesbenignindicationscountriesonepercentobjectivedemonstrateeasy-to-followstep-by-steprepairingtransvaginallyusingMETHODS:presentcase46-year-oldwomansimpletotalabdominalhysterectomycorrectusedinvolvesmobilizingaroundclosingpubo-vesicalfascialayersRESULTS:patientsuccessfulsurgicalcorrectionwithoutrecurrenceCONCLUSIONS:equivalentsuccessrateapproachesinvasivenessfasterrecoverytimesThereforereasonableusehelprestorequalitylifewomenaffectedSimpleeffective:FistulasurgerySurgicalVesicovaginal

Similar Articles

Cited By