Objective: To assess Latzko's colpocleisis with bilateral Martius flap as a solution for vesico vaginal fistula secondary to radiotherapy.
Method: 65 year old woman with past medical history of cervix adenocarcinoma treated with hysterectomy, pelvic radiotherapy and brachytherapy. She also had terminal colostomy for recto-vaginal fistula. She complained of a 2-year history of continuous urinary escape through vagina. On cistoscopy, the ureteral orifices were close to the loss of substance. Colpocleisis following Latzko's technique was performed.
Results: Complete resection of the fistulous tract and tension free closure is a surgical challenge not always achieved, and with a high recurrence rate. Latzko's colpocleisis is a simple and safe option in patients that have previously undergone a hysterectomy. Bilateral Martius flap increases vascular support of the affected tissues, which is of pivotal importance in patients subjected to radiotherapy.
Conclusion: Latzko's colpocleisis is a valid therapeutic option in those histerectomised patients with vesico vaginal fistulas due to radiotherapy who are not eligible for fistulorraphy.
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Vaginal approach to vesicovaginal fistula and vaginal vault prolapse preserving sexual function by Latzko repair and sacrospinous suspension.
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