To summarize feasibility and efficacy of transperitoneal laparoscopy in the treatment of vesicovaginal fistulas.

Between December 2012 and December 2017, 7 patients (aged 42-57 years) who had underwent open total hysterectomy (n=6) or radical resection of cervical cancer (n=1) caused vesicovaginal fistulas. The fistulas were located above the ureteral fistula, the fistula diameter was 0.5-3.5 cm, and the duration of urinary fistula was between 3 months and 5 years. Among them, 2 cases had a history of bladder repair failure 1-2 times. Laparoscopic repair of vesicovaginal fistulas was performed. Trocar was placed under direct vision. Five of them had large or recurrent vesicovaginal fistulas using an omentum to fill the gap between bladder and the vagina. Indwelling catheter for 2-3 weeks.

All operation were performed successfully, the operation time was 150-280 minutes and the blood loss was 50-150 ml. No blood transfusion was required. After the catheter was removed, the urine fistula disappeared. No urinary fistula occurred during 6-54 months of follow-up.

Laparoscopic repair of high vesico-vaginal fistula is minimally invasive and effective, especially in recurrent cases, but more clinical data are needed to demonstrate.