Importance: Data comparing perioperative outcomes between transvaginal, transabdominal, and laparoscopic/robotic vesicovaginal fistula (VVF) repair are limited but are important for surgical planning and patient counseling.
Objective: This study aimed to assess perioperative morbidity of VVF repair performed via various approaches.
Study Design: The American College of Surgeons National Surgical Quality Improvement Program database was used to identify women who underwent transvaginal, transabdominal, or laparoscopic/robotic VVF repair from 2009 to 2020. Associations of surgical approach with baseline characteristics, blood transfusion, prolonged hospitalization (>4 days), and 30-day outcomes (any major or minor complication or return to the operating room) were evaluated with χ 2 , Fisher exact, and Kruskal-Wallis tests. Multivariable logistic regression models assessed the adjusted association of approach with 30-day complications and prolonged hospitalization.
Results: Overall, 449 women underwent VVF repair, including 252 transvaginal (56.1%), 148 transabdominal (33.0%), and 49 laparoscopic/robotic procedures (10.9%). Abdominal repair was associated with a longer length of hospitalization (median, 3 days vs 1 day transvaginal and laparoscopic/robotic; P < 0.001), higher risk of prolonged length of stay (abdominal, 21.1%; transvaginal, 4.0%; laparoscopic/robotic, 2.0%; P < 0.001), major complications (abdominal, 4.7%; transvaginal, 0.8%; laparoscopic/robotic, 0.0%; P = 0.03), and perioperative transfusion (abdominal, 5.0%; transvaginal, 0.0%; laparoscopic/robotic, 2.1%; P = 0.01). On multivariable analysis, the abdominal approach was independently associated with an increased risk of prolonged hospitalization compared with laparoscopic/robotic (odds ratio, 12.3; 95% confidence interval, 1.63-93.21; P = 0.02) and transvaginal (odds ratio, 6.09; 95% confidence interval, 2.87-12.92; P < 0.001) but not with major/minor complications ( P = 0.76).
Conclusion: Transvaginal and laparoscopic/robotic approaches to VVF repair are associated with lower rates of prolonged hospitalization, major complications, and readmission compared with a transabdominal approach.
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Objective: Vesicovaginal fistula (VVF) is a pathological communication between the urinary bladder and the vagina. The most common cause of VVF is hysterectomy, while less common causes include obstetric trauma and pelvic surgery. Most cases require surgical intervention.
View Article and Find Full Text PDFTransvaginal repair of apical vesicovaginal fistula via vaginal natural orifice transluminal endoscopic surgery (V-NOTES): a modified surgical technique and its outcomes.
Sci Rep
December 2024
Department of Urology, Gongli Hospital of Shanghai Pudong New Area, 219 Miao Pu Road, Shanghai, 200135, China.
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- Outcomes showed an 88.2% success rate, with an average operative time of 104.2 minutes and minimal blood loss (10.45 ml).
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Robotic-Assisted Vesicovaginal Fistula Repair: A Comparative Analysis Between Hugo RAS and da Vinci Xi Systems.
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December 2024
Department of Urology, Apollo Hospitals, Chennai, India.
Article Synopsis
- The study aimed to compare the surgical outcomes of vesicovaginal fistula (VVF) repair using the Hugo RAS Medtronic robot and the da Vinci Xi robot.
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Our experience of laparoscopic vesicovaginal fistula repair in a tertiary care center.
Urol Ann
October 2024
Department of Urology, Indira Gandhi Institute of Medical Sciences, Patna, Bihar, India.
Objective: Laparoscopic repair of vesicovaginal fistula (VVF) is gaining popularity day by day, but we have limited literature on it. This study is to evaluate the safety, feasibility, and outcomes of laparoscopic VVF repair in a tertiary care center in Eastern India.
Subjects And Methods: This study is a single-center retrospective study in which 11 patients of supratrigonal VVF were evaluated who underwent laparoscopic repair.
Introduction: This study evaluates the safety and feasibility of the Medtronic Hugo robot-assisted surgery (RAS) system in gynecological and urogynecological procedures. Through a retrospective analysis of prospectively collected data from the first 100 surgeries performed at Apollo Hospitals Chennai, we aim to provide insights into the system's effectiveness, including outcomes, complications, and overall surgical efficiency in major gynecological and urogynecological operations.
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