Department of Urology, Peking University Third Hospital, Beijing, China; Department of Urology, Zhuhai People's Hospital (Zhuhai Hospital affiliated with Jinan University), Zhuhai, China.
Department of Plastic Surgery, Peking University Third Hospital, Beijing, China.
Urology. 2023 May;175:223-228. doi: 10.1016/j.urology.2023.02.036. Epub 2023 Mar 11.
We present a novel technique that combined endoscopic laser dissection and a transvesical laparoscopic approach for VVF repair in a transmasculine patient who received vaginal colpectomy. A literature review of VVF repair was also conducted.
Surgical repair of VVF has been described extensively in the literature. Transvaginal and transabdominal laparoscopic approaches are currently the most common techniques for VVF management. However, for transmasculine patients, neither of these methods is ideal due to either a previous history of vaginal colpectomy or the position of the fistula. This case report demonstrates the feasibility of applying a combined endoscopic laser dissection and transvesical laparoscopic approach for VVF repair.
The patient had an uneventful recovery, and the VVF healed over time. The advantages of this technique include a precise incision and dissection of the fistula orifice, clear exposure of the anatomic plane between the bladder and vaginal wall, and minimal injury to normal tissue. More cases are needed to demonstrate the effectiveness and complication rate of this technique in the future.
我们提出了一种新的技术，该技术结合了内镜激光解剖和经膀胱腹腔镜方法，用于修复接受阴道广泛切除术的跨性别男性患者的 VVF。我们还对 VVF 修复进行了文献回顾。
VF 的手术修复在文献中有广泛的描述。经阴道和经腹腹腔镜方法是目前 VVF 管理最常用的技术。然而，对于跨性别男性患者，由于先前的阴道广泛切除术史或瘘管位置，这两种方法都不理想。本病例报告证明了将内镜激光解剖和经膀胱腹腔镜方法联合应用于 VVF 修复的可行性。
患者恢复顺利，VF 随着时间的推移而愈合。该技术的优点包括对瘘口的精确切割和解剖、膀胱和阴道壁之间解剖平面的清晰暴露以及对正常组织的最小损伤。需要更多的病例来证明该技术在未来的有效性和并发症发生率。
