Endoscopic Repair of Vesicovaginal Fistula

Background: Vesicovaginal fistulas is the most frequent kind of urinary fistula in women. Treatment of vesicovaginal fistula (VVF) has been considered a significant clinical problem. We present a special technique and precautions were taken during the treatment of a small VVF using cystoscopic electrocoagulation using a Bugbee electrode to freshen the fistula margins. Postoperative follow-up period was uneventful. Endoscopic management of VVF is an effective and simple alternative to major and invasive reconstructive surgeries. Materials and Methods: Twenty women with VVF were offered transvesicoscopic repair of fistula. The procedure done underspinal (12 cases) or general anesthesia (8 cases). In lithotomy position, cystoscope had been performed. Electrocoagulation using a Bugbee electrode to freshen fistula margins for fistulas less than 1 cm. Patient was kept on Foleys catheter and anticholinergic drugs for three weeks postoperatively. Results: Twenty women with vesicovaginal fistulas, twelve cause by abdominal hysterectomy, seven by cesarean section, and one case cause by foreign body, underwent this surgical procedure. The procedure time range from 20 to30 minutes. The procedure was uneventful, with promising success rate of 95%. Conclusions: Transvesicoscopic correction of vesicovaginal fistula is safe, feasible, cost effective, with lower morbidity and results in earlier recovery.