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Published in: International Urogynecology Journal 8/2011

01-08-2011 | Original Article

Laser welding of vesicovaginal fistula—outcome analysis and long-term outcome: single-centre experience

Authors: Prem N. Dogra, Ashish K. Saini

Published in: International Urogynecology Journal | Issue 8/2011

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Abstract

Introduction and hypothesis

The aim of this study is to evaluate the efficacy and safety of laser welding of vesicovaginal fistula (VVF) at our centre.

Methods

Between January 1, 2001 and January 3, 2010, eight patients underwent laser welding of vesicovaginal fistula. The mean age was 44 years (35–55). The VVF were primary (failing to heal following conservative management) in five and secondary (recurring following primary repair) in three cases. The mean fistula size was 3 mm (range, 2–4). Neodymium yttrium aluminium garnet (YAG) laser was used for the initial case, and in the remaining seven cases, holmium YAG laser was used for circumferential welding of the fistula. Following the procedure, a catheter was kept for 3 weeks. The mean hospitalisation period was 1 day. The mean follow-up is 47 months (2–110).

Results

Seven patients were dry after catheter removal. In one patient, procedure was abandoned due to bleeding.

Conclusions

Laser welding of VVF is a simple, safe and efficacious procedure in a select group of patients.
Literature
1.
go back to reference Dogra PN, Nabi G (2001) Laser welding of vesicovaginal fistula. Int Urogynecol J Pelvic Floor Dysfunct 121(1):69–70CrossRef Dogra PN, Nabi G (2001) Laser welding of vesicovaginal fistula. Int Urogynecol J Pelvic Floor Dysfunct 121(1):69–70CrossRef
2.
go back to reference Zimmern PE, Hadley HR, Staskin D (1985) Genitourinary fistulas: vaginal approach for repair of vesicovaginal fistulas. Clin Obstet Gynaecol 12(2):403–413PubMed Zimmern PE, Hadley HR, Staskin D (1985) Genitourinary fistulas: vaginal approach for repair of vesicovaginal fistulas. Clin Obstet Gynaecol 12(2):403–413PubMed
3.
go back to reference Elkins T, Thompson J (1999) Lower urinary tract fistulas. In: Walters M, Karram M (eds) Urogynecology and reconstructive pelvic surgery. Mosby, St. Louis, pp 355–366 Elkins T, Thompson J (1999) Lower urinary tract fistulas. In: Walters M, Karram M (eds) Urogynecology and reconstructive pelvic surgery. Mosby, St. Louis, pp 355–366
4.
go back to reference Pettersson S, Hedelin H, Jansson I (1979) Fibrin occlusion of a vesicovaginal fistula. Lancet 1(8122):933PubMedCrossRef Pettersson S, Hedelin H, Jansson I (1979) Fibrin occlusion of a vesicovaginal fistula. Lancet 1(8122):933PubMedCrossRef
5.
go back to reference Hedelin H, Nilson AE, Teger-Nilsson AC (1982) Fibrin occlusion of fistulas postoperatively. Surg Gynecol Obstet 154(3):366–368PubMed Hedelin H, Nilson AE, Teger-Nilsson AC (1982) Fibrin occlusion of fistulas postoperatively. Surg Gynecol Obstet 154(3):366–368PubMed
6.
go back to reference Falk H, Orkin L (1957) Nonsurgical closure of vesicovaginal fistulas. J Obstet Gynaecol 9:538 Falk H, Orkin L (1957) Nonsurgical closure of vesicovaginal fistulas. J Obstet Gynaecol 9:538
7.
go back to reference Stovsky MD, Ignatoff JM, Blum MD (1994) Use of electrocoagulation in the treatment of vesicovaginal fistulas. J Urol 152(5 Pt 1):1443–1444PubMed Stovsky MD, Ignatoff JM, Blum MD (1994) Use of electrocoagulation in the treatment of vesicovaginal fistulas. J Urol 152(5 Pt 1):1443–1444PubMed
8.
go back to reference Margolis T, Elkins TE, Seffah J (1994) Full-thickness Martius grafts to preserve vaginal depth as an adjunct in the repair of large obstetric fistulas. Obstet Gynecol 84(1):148–152PubMed Margolis T, Elkins TE, Seffah J (1994) Full-thickness Martius grafts to preserve vaginal depth as an adjunct in the repair of large obstetric fistulas. Obstet Gynecol 84(1):148–152PubMed
9.
go back to reference Bass L, Treat M, Dzaknoski C, Trokel SL (1989) Sutureless microvascular anastomosis using the THC: YAG laser: a preliminary report. Microsurgery 10:189–193PubMedCrossRef Bass L, Treat M, Dzaknoski C, Trokel SL (1989) Sutureless microvascular anastomosis using the THC: YAG laser: a preliminary report. Microsurgery 10:189–193PubMedCrossRef
10.
go back to reference Benson R (1993) Tissue welding. In: Smith J Jr (ed) Lasers in urology surgery, 3rd edn. Mosby, St. Louis, pp 199–220 Benson R (1993) Tissue welding. In: Smith J Jr (ed) Lasers in urology surgery, 3rd edn. Mosby, St. Louis, pp 199–220
11.
go back to reference White R, White G, Fujian R et al (1959) Initial human evaluation of argon laser-assisted vascular anastomosis. J Vasc Surg 9:542–547 White R, White G, Fujian R et al (1959) Initial human evaluation of argon laser-assisted vascular anastomosis. J Vasc Surg 9:542–547
12.
go back to reference Poppas DP, Scherr DS (1998) Laser tissue welding: a urological surgeon’s perspective. Haemophilia 4:456–462PubMedCrossRef Poppas DP, Scherr DS (1998) Laser tissue welding: a urological surgeon’s perspective. Haemophilia 4:456–462PubMedCrossRef
Metadata
Title
Laser welding of vesicovaginal fistula—outcome analysis and long-term outcome: single-centre experience
Authors
Prem N. Dogra
Ashish K. Saini
Publication date
01-08-2011
Publisher
Springer-Verlag
Published in
International Urogynecology Journal / Issue 8/2011
Print ISSN: 0937-3462
Electronic ISSN: 1433-3023
DOI
https://doi.org/10.1007/s00192-011-1389-0

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