Abstract
The evidence on the treatment of vesicovaginal fistula is limited. While an initial attempt can be made by placing a transurethral catheter for 2–3 weeks in the hope that the fistula will close spontaneously, surgical repair will usually be necessary. There is no evidence that the timing of the repair makes a difference to the chances of successful closure of the fistula. There is no clear advantage of vaginal, abdominal, transvesical, or transperitoneal approaches. Laparoscopic and robotic approaches have been described but without showing any clear advantage over traditional approaches. Interposition grafts can be used, but there is little evidence to support their use. Urethral-vaginal fistula can be complicated by persisting stress incontinence, urethral strictures, or urethral shortening necessitating long-term follow-up. Surgeons involved in fistula surgery should have appropriate training, skills, and experience to select an appropriate procedure for each patient [1, 2].
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References
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Further Reading
Abrams P, Andersson KE, van AC V, Heesakers JP, et al. Fourth International Consultation on Incontinence. Recommendations of the International Scientific Committee: evaluation and treatment of urinary incontinence, pelvic organ prolapse, and fecal incontinence. Neurourol Urodyn. 2010;29:213–40.
EAU Guidelines 2015. http://www.uroweb.org.
Stein R, Schröder A, Thüroff JW. Bladder augmentation and urinary diversion in patients with neurogenic bladder: non-surgical considerations. J Pediatr Urol. 2012;8(2):145–52.
Vainrib M, Reyblat P, Ginsberg DA. Differences in urodynamic study variables in adult patients with neurogenic bladder and myelomeningocele before and after augmentation enterocystoplasty. Neurourol Urodyn. 2013;32(3):250–3.
Veenboer PW, Nadorp S, de Jong TP, et al. Enterocystoplasty vs detrusorectomy: outcome in the adult with spina bifida. J Urol. 2013;189(3):1066–70.
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De Ridder, D., Laturnus, J.M., Sievert, KD. (2016). Reconstructive Surgery. In: Heesakkers, J., Chapple, C., De Ridder, D., Farag, F. (eds) Practical Functional Urology. Springer, Cham. https://doi.org/10.1007/978-3-319-25430-2_11
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DOI: https://doi.org/10.1007/978-3-319-25430-2_11
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