PMC8118741_01
Fistula tract visualized by rigid cystourethroscopy in the urinary bladder.
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fig1
The procedure showed a fistula tract on the anterior vaginal wall extending medially into the bladder just posterior to the trigone (Figure 1).
Ureteral catheters (yellow) retracted away from the operative field. A 10F Foley catheter was shown exiting the fistula tract along the anterior vaginal wall just inferior to the metal retractor.
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fig2
The setup was completed and we moved forward with the fistula repair (Figure 2).
Biologic graft made of human cadaveric dermis placed over the fistula tract using allis clamps.
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fig3
With the 3-0 Vicryl on a UR6, we placed the dermis in a quilted fashion overlying the repair (Figure 3).
Completed fistula repair using colpocleisis to obliterate the vaginal opening.
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fig4
We concluded by trimming and closing the vaginal mucosa, thereby finishing the colpocleisis to provide the extra layer of support (Figure 4).