Vesicovaginal fistulas – current therapeutical strategy

Abstract

Abstract Objectives: Clinical evaluation of Latzko operation in primary and recurrent vesicovaginal fistulas and an update on current therapeutical strategy. Material and methods: Evaluation of clinical efficacy has been performed in a group of 5 patients with confirmed vesicovaginal fistulas and in 1 woman with urethrovaginal fistula. Prior to the operation, four patients had undergone eight fistula operations in our department with unsuccessful outcome. Results: Fistula closure by Latzko operation has been achieved in 5 patients, including one patient who had surgery treatment repeated 3 months after the primary fistula operation. In total, additional Martius flap has been introduced twice. In patient, where fistula has been operated after 45 days since primary TVM and IVSO4 surgery, closure therapy failed. Conclusions: Surgical treatment by vaginal approach offers great therapeutical efficacy in the primary and recurrent vesicovaginal fistulas, even in cases when previous abdominal surgical treatment had failed.