Vesicovaginal Fistula: Epidemiology, Diagnostics and Robotic Assisted Repair with Peritoneal Flap Inlay

The Latin term for fistula is “pipe” or “tube” and means an extra-anatomic anastomosis between two hollow organs (or an hollow organ and the environment). A fistula between the lower urinary tract and the vagina is termed vesicovaginal (VVF) or vesicourethral fistula. It will lead to a permanent leckage of urine from the bladder through the vagina which has a devastating impact on quality of life of the woman; in high income countries, both fistula are almost exclusively iatrogenic, but may also result from, malignancy, inflammation or appear as congenital fistula. The reconstructive robotic approach for a vesico-vaginal fistula is considered to be a safe option treatment option with a standardized technique with flap interpositions. The development of advanced reconstructive robotic urology has led to a minimal invasive approach in the routine even in complex re-do surgeries, providing excellent and safe results.