The Latzko transvaginal vesicovaginal fistula repair is a highly effective treatment
for even complex fistulae. Our video demonstrates the Latzko repair technique and
its application in a variety of circumstances that include fistula management concurrent
with treatment of uterovaginal prolapse, after complex urologic surgery, and in the
postpartum setting after urologic injury. The technique of the procedure varies only
slightly in these diverse conditions. The basic steps begin with hydro-dissecting
the epithelium from the underlying fascia surrounding the fistula tract, followed
by denuding the epithelium within a circumscribing incision around the fistula. The
fistula is then closed with a purse-string suture placed just outside the epithelialized
tract. Next, several layers of imbricating sutures are placed to close the defect.
Finally, the vaginal epithelium is closed.
Key words
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to American Journal of Obstetrics & GynecologyAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Latzko operation for vault vesicovaginal fistula.Acta Obstet Gynecol Scand. 2006; 85: 1248-1251
- The post-total hysterectomy (vault) vesicovaginal fistula.J Urol. 1980; 123: 839-840
- Management of vesicovaginal fistulas (VVFs) in women following benign gynaecologic surgery: a systematic review and meta-analysis.PLoS One. 2017; 12: e0171554
- Which surgical technique should be preferred to repair benign, primary vesicovaginal fistulas?.Urol J. 2015; 12: 2422-2427
- Vaginal approach to vesicovaginal fistula and vaginal vault prolapse preserving sexual function by Latzko repair and sacrospinous suspension.Female Pelvic Med Reconstr Surg. 2012; 18: 306-307
Article Info
Publication History
Published online: May 20, 2019
Accepted:
May 14,
2019
Received in revised form:
May 8,
2019
Received:
March 7,
2019
Footnotes
The authors report no conflict of interest.
Cite this article as: Kieserman-Shmokler C, Sammarco AG, English EM, et al. The Latzko: A high-value, versatile vesicovaginal fistula repair. Am J Obstet Gynecol 2019;221:160.e1-4.
Identification
Copyright
© 2019 Elsevier Inc. All rights reserved.
