The feasibility and outcome of laparoscopic vesicovaginal fistula repair as a minimally invasive technique: a retrospective descriptive monocentric study.

Introduction: vesicovaginal fistula (VVF) is the most common type of urogenital fistula. The laparoscopic approach to VVF repair offers the advantage of minimally invasive surgery with similar principles to the open trans-abdominal approach. The purpose of our study was to evaluate the transperitoneal laparoscopic approach as a minimally invasive tool for VVF repair. Methods: this was a retrospective study including 14 patients with VVF who underwent transperitoneal laparoscopic fistula repair between 2016 and 2020 in the urology department of the university hospital, Kairouan. Patients had undergone surgery at least six months after their primary gynecological surgery and were followed during 9 months after laparoscopic fistula repair. Data regarding patients' characteristics, operative data, and outcomes were gathered. The main outcome was the success rate of VVF closing and postoperative complications. Results: fourteen patients were included. The patient's mean age was 34.8±8.2years. Size of fistula varied from 0.5 to 2cm and all the VVF were supratrigonal. The mean operative time was 145±23.4 minutes with no significant blood loss. The mean hospital stay was 4±1.4 days without major complications. Regarding analgesia, paracetamol was used for the first two days to meet the analgesia needs of all patients, and morphine was used in three cases (21.4%). During follow-up, two patients were re-operated for early recurrence (14.2%) and the total success rate was 85.7% (12 patients). Conclusion: the laparoscopic repair of VVF is a safe, effective, minimally invasive procedure, and without major complications.

Unusual presentation of extended iliofemoral deep vein thrombosis caused by giant retroperitoneal abscess: a rare case report.

Secondary deep vein thrombosis due to a mass effect on the venous system has been reported in the literature. Venous thrombosis is frequently seen in the lower extremities; however, when seen at the iliac level, the mass effect of an underlying pathology must be considered. Identifying such etiologies guides the management and reduces the risk of recurrences. Case Presentation: In this report, the authors present a case of an extended iliofemoral vein thrombosis caused by a giant retroperitoneal abscess (RA) in a 50-year-old woman with underlying type 2 diabetes mellitus, presenting with painful left leg swelling and fever. Color venous Doppler ultrasonography and computed tomography scan of the abdomen and pelvis findings were compatible with a left voluminous RA compressing the left iliofemoral vein with an extended deep vein thrombosis. Conclusions: The mass effect on the venous system is rare in RAs, but it must be kept in mind. In light of this case and literature review, the authors highlight the diagnosis and management difficulties in handling this unusual presentation form of a RA.