Transurethral suture cystorrhaphy for repair of vesicovaginal fistulas: Evolution of a technique

Technical difficulties in the initially described transurethral repair of v esicovaginal fistulas have led to several modifications in technique. In an uncontrolled trial, these modifications included the use of a suprapubic t ract, along with an arthroscope for visualization of the fistula. A large-c aliber port is passed per urethram for transurethral instrumentation access . New-generation laparoscopic needle driver technology markedly improves th e ease of transurethral suturing. Three previously unreported vesicovaginal fistula patients have had successful resolution of their fistulas after un dergoing transurethral repair. Small-diameter vesicovaginal fistulas in sel ected patients can be successfully repaired by a minimally invasive transur ethral suture technique.