Endoscopic Laser Dissection Combined With Laparoscopic Pneumovesical Repair of Vesicovaginal Fistula: A Novel Technique and Case Report

Abstract

Introduction: We present a novel technique that combined endoscopic laser dissection and a transvesical laparoscopic approach for VVF repair in a transmasculine patient who received vaginal colpectomy. A literature review of VVF repair was also conducted.

Technical considerations: Surgical repair of VVF has been described extensively in the literature. Transvaginal and transabdominal laparoscopic approaches are currently the most common techniques for VVF management. However, for transmasculine patients, neither of these methods is ideal due to either a previous history of vaginal colpectomy or the position of the fistula. This case report demonstrates the feasibility of applying a combined endoscopic laser dissection and transvesical laparoscopic approach for VVF repair.

Conclusion: The patient had an uneventful recovery, and the VVF healed over time. The advantages of this technique include a precise incision and dissection of the fistula orifice, clear exposure of the anatomic plane between the bladder and vaginal wall, and minimal injury to normal tissue. More cases are needed to demonstrate the effectiveness and complication rate of this technique in the future.