Laparoscopic Vesicovaginal Fistula Repair: Report of Five Cases, Literature Review, and Pooling Analysis

Objective: This study assessed the safety and efficacy of laparoscopic repair of vesicovaginal fistula (VVF) by literature review and pooling analysis, and this is the first report of the experience of using this approach in a patient with a history of radiotherapy. Subjects and Methods: Five patients with VVF, including one with a history of cervical cancer and radiation, underwent laparoscopic repair from August 2010 to December 2011 performed by the same experienced surgeon. Results: The surgical procedure was uneventful in all of the patients, and no conversion to open surgery was required. Mean operation time was 134 minutes (range, 100-185 minutes). Mean blood loss was 300mL (range, 250-370 mL), and no one required blood transfusion. Mean hospital stay was 4 days (range, 3-6 days). Laparoscopic repair was successful in 4 patients at the mean follow-up period of 8 months (range, 2-15 months), even in the patient with a history of radiotherapy. VVF recurred in 1 subject, who underwent repeat laparoscopic repair, and 2-month follow-up revealed no fistula. Conclusions: Laparoscopic surgery may be a good alternative to the open approach to manage even complicated VVF if it is performed by skilled surgeons.