Laparoscopic/ Robotic: Other

Moderated Poster Session

MP17-6 - Long-term outcomes of laparoscopic repair of vesicouterine fistula: Experience from a tertiary care centre of northern India

Saturday, September 22
10:00 AM - 12:00 PM
Location: Room 252B

Introduction & Objective :

Vesicouterine fistula (VUF) is a rare cause of female genito-urinary fistula. It comprises 1-4% of all urogenital fistulas. Most of these fistulas occur due to lower segment caesarean section (LSCS). The incidence of VUF is increasing because of increasing prevalence of caesarean section.  raditionally, open surgical repair has been the treatment of choice. However, laparoscopic repair of VUF is a minimally invasive technique and few case reports have been published with short term follow up. In the current study, we are presenting our long- term outcomes of laparoscopic repair of VUF


Methods :

A retrospective analysis of patients was performed who underwent laparoscopic repair of VUF between 2010 and 2017 after approval of Institutional Review Committee. Nine patients had history of LSCS of whom 3 had history of prolonged obstructed labour and 1 patient had history of dilatation and curettage for medical termination of pregnancy. Radiological imaging included ultrasound of kidney, ureter and bladder for all patients and hysterosalpingography (HSG) in 4 patients and contrast enhanced computed tomography scan in all patients.


Results :

The most common presentation was cyclical menstrual bleeding through urine (menouria) in 9 of 10 patients, associated amenorrhea in 7 and vaginal leakage of urine in 3 cases. Median age of the patient was 28.3 years (range, 22-37), and median postoperative follow up was 2.3 years (range, 1 -4). All patients underwent transperitoneal laparoscopic repair of VUF with successful outcomes (Table-1). The mean operating time was 158.7±16.9 min (range, 135-186 min) with a median blood loss of 100 mL (range, 50-210 mL). All patients were advised not to become pregnant for 1 year following laparoscopic repair. Three patients conceived in follow-up and all delivered normal baby by LSCS


Conclusions :

Laparoscopic repair of VUF is a safe and effective minimally invasive technique with successful pregnancy in long- term follow up

Vishwajeet Singh

Professor
Department of Urology, King George's Medical University, Lucknow, INDIA

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    Siddharth Pandey

    Senior Resident
    Department of Urology, King George's Medical University, Lucknow, INDIA

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      Seema Mehrotra

      Professor
      Department of Obstetrics and Gynaecology, King George's Medical University, Lucknow, INDIA

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        Rahul J. Sinha

        Associate Professor
        Department of Urology, King George's Medical University, Lucknow, INDIA

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