Vesicovaginal fistulas (VVFs) represent a challenging scenario for both the patient and surgeon. Many considerations must take place in advance of repair, including diagnosis of the fistula (visualization, dye test,…
Preoperative Preparation and Planning Traditionally, it has been recommended to wait a minimum of 3 months after vesicovaginal fistula (VVF) diagnosis or last attempted repair before proceeding with repair because…
An abdominal approach to vesicovaginal fistula (VVF) repair should be considered in large, complex, supratrigonal fistulas in the setting of ureteral involvement, small-capacity bladder requiring augmentation, previously irradiated tissue, immobile…
We gratefully acknowledge the contribution of Dr. John Pope, who authored this chapter in previous editions. When a patient is in need of bladder augmentation and a significantly dilated ureter…
Sigmoid cystoplasty was described by Lemoine in 1912 and has been used extensively. The sigmoid colon’s proximity to the bladder and reliable blood supply has made it an attractive option…
Background Historically, as early as 1852, Simon reported the first continent urinary diversion by creating a fistula between the ureters and the rectum in a patient with bladder exstrophy. The…
In this chapter, the surgical technique for constructing an ileal orthotopic bladder substitute combined with an afferent tubular segment is described. This reservoir with a low pressure and high compliance…
Patient and Preoperative Preparation Patients being considered for laparoscopic radical cystectomy (LRC) or robot-assisted radical cystectomy (RARC) should undergo complete metastatic and staging evaluation. Particular attention needs to be paid…
It is wise to first use less invasive measures when possible and proceed to augment only if these prove insufficient. Videourodynamic evaluation provides information about bladder compliance, overactivity, outlet resistance,…
Introduction and Historical Perspective The Indiana pouch has become one of the most popular forms of catheterizable continent urinary diversions over the past 3 decades, serving a purpose for patients…
