Supervene of vesicovaginal fistula after open total hysterectomy with concurrently bladder repair in an outer unit: successful surgical management with robotic surgery and clinical follow-up

Abstract

While vesicovaginal fistula (VVF) is not common in developed countries, it is a significant health problem in developing countries. In developed nations, these fistulas are usually unfortunate complications of gynecologic or other pelvic surgery and radiotherapy. Once a vesicovaginal fistula is suspected, a meticulous vaginal examination should be performed to identify its size, location, and relation to the trigone. Even though there is no consensus on which approaches are better, surgical and conservative are two options. In terms of the surgical option, there are numerous approaches such as abdominal, vaginal, and minimally invasive surgery (i.e., laparoscopic and robotic). The treatment algorithm depends on surgeons’ training and experience, facilities, anatomical localization. Recently, minimally invasive surgery is preferred to provide low morbidity and higher success rate. Therefore, if it is suitable, patientsshould be referred to the tertiary care center and the treatment process management with a multidisciplinary team including the department of urology, radiology, interval radiology, and urogynecology.