A Multi-Institutional Experience with Robotic Vesicovaginal and Ureterovaginal Fistula Repair After Iatrogenic Injury.
J Endourol
; 35(11): 1659-1664, 2021 11.
Article
en En
| MEDLINE
| ID: mdl-33787314
ABSTRACT
Objectives:
To describe our multi-institutional experience with robotic repair of iatrogenic urogynecologic fistulae (UGF), including vesicovaginal fistulae (VVF) and ureterovaginal fistulae (UVF).Methods:
We performed a retrospective review identifying patients who underwent robotic repair of VVF and UVF between January 2010 and May 2019. All patients failed conservative management with Foley catheter or upper tract drainage (ureteral stent and/or nephrostomy tube), respectively. Patient demographics and perioperative outcomes were analyzed. Success was defined as no vaginal leakage of urine postoperatively, in the absence of drains, catheters, or stents.Results:
Of 34 patients, 22/34 (65%) had VVF and 12/34 (35%) had UVF repair. VVF etiology included radiation (1/22, 4.5%) and surgery (21/22, 95.5%). Four of 22 (18%) had undergone prior repair attempt. Median console time was 187 minutes (interquartile range [IQR] 151-219), estimated blood loss (EBL) was 50 mL (IQR 50-93), and median length of stay (LOS) was 1 day (IQR 1-2). Two of 22 (9%) patients had a postoperative complication. At mean follow-up of 28.9 months, 20/22 (91%) VVF cases were clinically effective. UVF etiology was gynecologic surgery in all cases; 8/12 (67%) were left-sided, 4/12 (33%) were right-sided. None was repeat repairs. Two of 12 (17%) underwent ureteroureterostomy, and 10/12 (83%) had reimplant. Median console time was 160 minutes (IQR 133-196), EBL was 50 mL (IQR 50-112), and LOS was 1 day (IQR 1-1). No complications were encountered. At mean follow-up of 29.3 months, 100% of UVF repairs were effective.Conclusions:
Robotic repair of iatrogenic UGF may be effectively performed with low complication rates by experienced urologic surgeons.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Fístula Vaginal
/
Fístula Vesicovaginal
/
Procedimientos Quirúrgicos Robotizados
Tipo de estudio:
Etiology_studies
/
Observational_studies
Límite:
Female
/
Humans
Idioma:
En
Revista:
J Endourol
Asunto de la revista:
UROLOGIA
Año:
2021
Tipo del documento:
Article
País de afiliación:
Estados Unidos