John R Miklos1, Robert D Moore. 1. Atlanta Urogynecology Associates, Atlanta, GA, USA. JohnRMiklos@yahoo.com
Abstract
BACKGROUND: Conventional wisdom suggests that vascular interposition flaps are helpful in the treatment of all patients with vesicovaginal fistulas. Complicated fistulas are often treated with interposition omental flaps; however, failed omental flap repairs have not been described without the use of another interposition flap. CASE: A 52-year-old woman with a history of cystotomy repair at the time of hysterectomy and a subsequent abdominal omental flap vesicovaginal fistula repair failure underwent a successful repair using a laparoscopic-layered closure of her fistula without omental flap. CONCLUSION: A failed omental flap vesicovaginal fistula repair can be repaired laparoscopically and without an omental flap.
BACKGROUND: Conventional wisdom suggests that vascular interposition flaps are helpful in the treatment of all patients with vesicovaginal fistulas. Complicated fistulas are often treated with interposition omental flaps; however, failed omental flap repairs have not been described without the use of another interposition flap. CASE: A 52-year-old woman with a history of cystotomy repair at the time of hysterectomy and a subsequent abdominal omental flap vesicovaginal fistula repair failure underwent a successful repair using a laparoscopic-layered closure of her fistula without omental flap. CONCLUSION: A failed omental flap vesicovaginal fistula repair can be repaired laparoscopically and without an omental flap.