AUGS/IUGA Scientific Meeting 2019-Abdominal Closure of Complex Vesicovaginal Fistula Using the O'Conor Technique

Abdominal Closure of Complex Vesicovaginal Fistula Using the O'Conor Technique

Video Transcription

Video Summary

In this video, the O'Connor technique is demonstrated for the closure of a complex vesicovaginal fistula resulting from neglected pessary use. The case involves a 76-year-old woman with a large 4-centimeter fistula caused by prolonged pessary placement. An abdominal approach is taken due to the size and complexity of the fistula, and a hysterectomy is performed to provide better access to the vesicovaginal space. The O'Connor technique, a transabdominal transvesical approach, is used for the repair. The steps include mobilization of the bladder, intentional high cystotomy, dissection of the fistula components, ureteral reimplantation, and tension-free closure with omental interposition graft. A successful closure is achieved, and the patient recovers well postoperatively. The O'Connor technique is considered the gold standard for supratrigonal vesicovaginal fistula repair. No credits were granted for this video.

Asset Caption

Joseph Panza, MD

Keywords

O'Connor technique

closure

complex vesicovaginal fistula

neglected pessary use

transabdominal transvesical approach