METHOD FOR SURGICAL REPAIR OF VESICOVAGINAL FISTULAS Russian patent published in 2024 - IPC A61B17/04 

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely to surgical urology. Localization and size of vesicovaginal fistula, its relation to mouths of ureters and internal opening of urethra are estimated transvesically. Then the mouths of both ureters are catheterized, the fistula edges are excised along its entire length, including the vaginal walls, which are separated from the bladder wall, after that, circular sutures of absorbable material are applied on vaginal walls. Ends of the suture ligatures are brought out through the vagina and tied up by screwing the vaginal wall inside. Thereafter, the bladder wall defect is closed in two rows, and the sutures are tied in the bladder cavity. First row of sutures is applied on the detrusor muscle or its fragments. Further, an isolated portion of this muscle is taken from the rectus muscle, in proportion to the obtained detrusor suture, the muscle is anchored to this suture with ligatures. Then a second row of sutures is applied on the defect of the mucous membrane and submucosal layer of the bladder wall above the portion of the rectus abdominis muscle sutured to the detrusor suture so that the suture is adjacent to the rectus muscle tissue above the sutured detrusor. After removing the catheters from the orifices of the ureters, a cystostoma is left in the bladder. Ointment tampon is introduced into vagina for 1-2 days.

EFFECT: method enables improving the healing of the double-row suture of the bladder after excision of the vesicovaginal fistula.

1 cl, 1 ex