Large vesicovaginal fistula in women with pelvic organ prolapse: the role of colpocleisis revisited

Abstract

Successful repair of large vesicovaginal fistulas poses a significant challenge in surgically unfit older women with pelvic organ prolapse. Two women, at ages of 85 and 93, referred for involuntary urine loss were found to have neglected pessaries resulting in large vesicovaginal fistulas. After the removal of the pessary, fistula repair and LeFort colpocleisis were done with success. At 12 months postoperatively, the patients were free of leakage and prolapse. For frail, elderly women with large vesicovaginal fistula and pelvic organ prolapse, addition of LeFort colpocleisis to the repair provides an effective treatment for both.

Successful Case of Conservative Treatment of Vesicovaginal Fistula by Hodge Pessary Insertion

“…Until now, 11 cases with VVF caused by vaginal pessary were reported in the literature . VVF caused by vaginal pessary was successfully managed by using the Latzko partial colpocleisis technique in some cases .…”

Vaginal Approach to Vesicovaginal Fistula and Vaginal Vault Prolapse Preserving Sexual Function by Latzko Repair and Sacrospinous Suspension

“…There are reports of concomitant prolapse and fistula repair by performing a Latzko procedure and LeForte colpocleisis [2, 3]. Although this is a simple and effective option for women who are not sexually active, there is little in the literature to guide surgeons in the case of a woman who is sexually active and has a VVF and prolapse.…”

“…Its occurrence with complete vaginal vault eversion is even less common. Information about different operative approaches is limited to recommendations for colpocleisis [2, 3] which would not preserve sexual function. In this report, we describe management of this combination of problems to minimize postoperative morbidity and preserve a woman’s ability to have vaginal intercourse.…”

The Impact of the Treatment of Pelvic Organ Prolapse with Pessary on Quality of Life and Visual Analog Scale-Case Series

“…Bu çalışmalardan sadece iki tanesinin ülkemizden oluşu, Türkiye'de pesser kullanımının bu kadar sık olmadığını düşündürmektedir. 7,8 Hâbuki POP'de, genel olarak, başarılı bir tedavi yöntemi olarak kabul görmektedir. 9 Çalışmamızın amacı, kliniğimizde pesser ile tedavi edilmiş olguların tedaviden memnuniyetlerini ve ne kadar fayda gördüklerini incelemek, deneyimlerimizi paylaşmaktır.…”