Laser welding of vesicovaginal fistula

The management of vesicovaginal fistula remains a source of debate, despite extensive literature on the subject. It is difficult to prove the superior ity of one surgical technique over another by randomized trials, given the variabilities of fistula etiology, the location and clinician expertise. Sm all epithelized fistulae following conservative treatment and residual or r ecurrent cases following transabdominal or transvaginal repair pose a thera peutic challenge. A case of a small vesicovaginal fistula following abdomin al hysterectomy is presented, in which a successful outcome was achieved us ing endoscopic Nd-YAG laser fulguration.