Year: 2024 | Month: December | Volume: 14 | Issue: 12 | Pages: 106-111
DOI: https://doi.org/10.52403/ijhsr.20241212
Urogynaecological Management by Minimal Access Surgery
Dr. Shrenik J. Shah1, Dr. Kapil Kachhadiya2, Dr Pratik Chaudhary3, Dr Piyush Baraiya4, Dr Rahul Dhabalia5, Dr Sajid Nurbhai6
1,2,3,4,5,6Department of Urology, B J Medical College, Gujarat University, Ahmedabad, India.
Corresponding Author: Dr. Shrenik J. Shah
ABSTRACT
Background: Vesicovaginal fistulas (VVFs), ureteric injuries, and bladder trauma are significant urogynecological complications frequently associated with obstetric and gynaecological surgeries. This study evaluates the outcomes of minimal access surgery (MAS) in managing these conditions over a 15-year period at a tertiary care centre.
Methods: A retrospective review was conducted of 92 cases managed at the Urology Department, B.J. Medical College, Ahmedabad, between March 2009 and March 2024. Data included 88 laparoscopic VVF repairs and 4 laparoscopic ureteric reconstructions (Boari flap and ureteroureterostomy).
Results: Among 88 VVF cases, 55 were associated with total abdominal hysterectomy, 20 with vaginal hysterectomy, and 12 with laparoscopic hysterectomy. Recurrence occurred in 5 cases (5.6%), managed successfully with re-surgery. Wound infections were noted in 3 patients. Ureteric injuries (n=15) were managed using postoperative DJ stenting (10 cases), Boari flap reconstruction (3 cases), and laparoscopic ureteroureterostomy (2 cases). Late presentations (>6 months) yielded better outcomes, with fewer complications and recurrences compared to early presentations (<1 month).
Conclusion: Laparoscopic management of VVFs and ureteric injuries demonstrates high success rates, minimal complications, and improved outcomes for delayed presentations. MAS represents a preferred modality for urogynecological injury management due to its efficacy and reduced morbidity.
Key words: Laparoscopic, repair, fistula, stricture, urogynaecological, surgery, vesicovaginal, complications, minimally invasive, outcomes.