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Vesicovaginal Fistula (VVF)

Vesicovaginal Fistula (VVF)

Vaginal vault prolapse occurs when pelvic floor muscles and ligaments are stretched and/or weakened, causing the bladder to sag into the vagina. In severe cases, the bladder can appear at the vagina’s opening or protrude through it. Women who have had multiple pregnancies or deliver children vaginally are at a higher risk for prolapse.

Causes of a Vesicovaginal Fistula

There are several common causes for a vesicovaginal fistula:

  • Surgeries around the vagina such as an open hysterectomy
  • Radiation treatment for pelvic cancer
  • Inflammatory bowel diseases such as Crohn’s disease or ulcerative colitis
  • Deep tears caused by childbirth

While a vesicovaginal fistula is often painless, the most common symptom is fluid leakage from the vagina.

Diagnosis

After discussing any symptoms and related surgeries or trauma to the area, a urologist will perform a cystoscopy, which will reveal the opening of the fistula between the bladder and vagina. A urinalysis or blood test may also be performed to check for infections as well as an X-ray to determine the amount of tissue damage.

Treatments

Surgery is performed to repair a vesicovaginal fistula. A robotic vesicovaginal fistula repair is an effective option for patients with this condition.

Robotic Surgery

TUCC surgeons lead the region in performing urologic robotic surgery, having performed more than 5,000 procedures since 2006.

Each year, TUCC surgeons perform the highest number of robotic ureteral reimplantations and vesicovaginal fistula repairs in the Rocky Mountain region. In 2011, TUCC physician Elias Hsu, M.D., performed the first robotic-assisted laparoscopic vesicovaginal fistula repair in Denver.

By utilizing robotic technology, a surgeon’s hand movements are motion scaled and any hand tremor is filtered resulting in perfectly translated, precise movements of the instruments. Using the minimally invasive da Vinci robotic surgical system, surgeons performing a robotic surgery make several ½ inch (key-hole) incisions through which the surgery is performed. During the surgery, a telescopic camera lens is inserted into one of the small incisions for pristine vision, allowing the surgeon to preserve the nerves, normal tissues and surrounding muscle. In cases of vesicovaginal fistula repair, this allows surgeons to identify and repair the tissue causing the fistula.

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