Transvaginal flap-fistula repair with offset suturing for vesicovaginal fistula
- 1Department of Urology, First Affiliated Hospital of Kunming Medical University, Kunming, China
Abstract
Vesicovaginal fistula (VVF) is the most common type of urogenital fistula. It is typically caused by iatrogenic injuries, such as those sustained during pelvic surgery. Transvaginal repair is considered the preferred approach due to its minimally-invasive nature. However, the traditional Latzko procedure or layered closure techniques often sacrifice an excessive amount of vaginal wall tissue, which can lead to postoperative vaginal shortening and dyspareunia. This study aimed to introduce a modified transvaginal flap-fistula offset repair technique. This technique utilizes offset suturing of anatomical layers, not only improving the fistula closure rate but also maximally preserving vaginal length and function. A 48-year-old patient who developed VVF following total hysterectomy successfully underwent this procedure, with the operative time of 45 minutes and an estimated intraoperative blood loss of 5 ml. The urinary catheter was removed 4 weeks postoperatively, and the patient experienced no leakage. At 3-month follow-up, cystoscopy showed complete closure of the fistula. Vaginal anatomical morphology and length recovered well, with no sexual dysfunction. The Female Sexual Function Index score improved from 6 points preoperatively to 27 postprocedure. The transvaginal flap-fistula repair using an offset method can construct a robust tissue barrier and help avoid overlapping suture lines. It is a safe, effective, and minimally-invasive option that maintains vaginal length.
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BibTeX
@article{wang2026transvaginal,
title = {{Transvaginal flap-fistula repair with offset suturing for vesicovaginal fistula}},
author = {Xing-Qi Wang and Yi-Ling Cui and Ling Li and Ji-Hong Shen},
journal = {Videosurgery and other Miniinvasive Techniques},
year = {2026},
month = jul,
doi = {10.20452/wiitm.2026.18039},
url = {https://doi.org/10.20452/wiitm.2026.18039},
note = {CC BY-NC-SA 4.0},
}
RIS
TY - JOUR
TI - Transvaginal flap-fistula repair with offset suturing for vesicovaginal fistula
AU - Xing-Qi Wang
AU - Yi-Ling Cui
AU - Ling Li
AU - Ji-Hong Shen
PY - 2026
DA - 2026/07/09
JO - Videosurgery and other Miniinvasive Techniques
DO - 10.20452/wiitm.2026.18039
UR - https://doi.org/10.20452/wiitm.2026.18039
AB - Vesicovaginal fistula (VVF) is the most common type of urogenital fistula. It is typically caused by iatrogenic injuries, such as those sustained during pelvic surgery. Transvaginal repair is considered the preferred approach due to its minimally-invasive nature. However, the traditional Latzko procedure or layered closure techniques often sacrifice an excessive amount of vaginal wall tissue, which can lead to postoperative vaginal shortening and dyspareunia. This study aimed to introduce a modified transvaginal flap-fistula offset repair technique. This technique utilizes offset suturing of anatomical layers, not only improving the fistula closure rate but also maximally preserving vaginal length and function. A 48-year-old patient who developed VVF following total hysterectomy successfully underwent this procedure, with the operative time of 45 minutes and an estimated intraoperative blood loss of 5 ml. The urinary catheter was removed 4 weeks postoperatively, and the patient experienced no leakage. At 3-month follow-up, cystoscopy showed complete closure of the fistula. Vaginal anatomical morphology and length recovered well, with no sexual dysfunction. The Female Sexual Function Index score improved from 6 points preoperatively to 27 postprocedure. The transvaginal flap-fistula repair using an offset method can construct a robust tissue barrier and help avoid overlapping suture lines. It is a safe, effective, and minimally-invasive option that maintains vaginal length.
SN - 1895-4588
SN - 2299-0054
ER -