Surgical treatment of vesicovaginal fistula: transabdominal approach
Vesicovaginal fistula (VVF) is an abnormal communication between the bladder and the vagina. When surgical repair is indicated, approach selection and technique depend on fistula characteristics and patient history. The transabdominal route is one of the established surgical strategies for VVF repair.
Surgical approach
The transabdominal approach — available as open, laparoscopic, or robotic-assisted laparoscopic surgery — allows access to the fistula via either a transvesical or extravesical technique. Certain patient and fistula characteristics inform the additional use of tissue interposition during repair.
References
- A transabdominal approach, including open, laparoscopic, and robotic-assisted laparoscopic techniques, is the second most common approach to VVF surgical treatment.
- The transabdominal approach may be performed using either a transvesical or extravesical technique.
- The traditionally performed technique is the transvesical bivalve bladder technique (O'Conor technique).
- Although omental flap interposition is not routinely performed, it should be performed in patients with recurrent VVFs, large fistulas, irradiated tissue, or obstetric fistulas.