• Chuanfeng Liu, Shouxia Cao, Haiyan Liu, Qingtan Pang, Zichao Zhao, Fuming Wang, and Yongqiang Xia.
• Department of Urology, Linyi Maternity and Child Health Care Hospital, Shandong Province, China.
• Medicine (Baltimore). 2024 Oct 11; 103 (41): e39881e39881.

RationaleComplex vesicovaginal fistulas (VVFs) with large defects pose significant surgical challenges. Traditional repair methods often require extensive tissue separation and multilayer suturing, risking local blood supply and healing. This study introduces a novel modified transvaginal repair technique that simplifies the procedure while preserving tissue vascularity. It employs double-layer parallel in situ suturing for early repair of complex VVF.Patient ConcernsA 50-year-old woman was admitted with continuous vaginal urine leakage for 4 days following trauma. Speculum examination revealed a 3-cm longitudinal oval laceration at the 11 o'clock position in the dorsal lithotomy site, with continuous fluid leakage through the fistula.DiagnosesSelf-inflicted complex VVF.InterventionsThe patient underwent prophylactic placement of bilateral double-J stents and continuous catheterization, followed by surgical repair using a modified transvaginal technique involving double-layer parallel in situ suturing.OutcomesPostoperative evaluations showed successful healing with no urinary leakage. The vaginal sutures were removed on day 24, and follow-up at 1 year confirmed no recurrence of the fistula or lower urinary tract symptoms, significantly improving the patient's quality of life.LessonsThe modified transvaginal repair technique using double-layer parallel in situ suturing is a simple and effective approach for early repair of complex VVF, highlighting its potential for broader clinical application. Future studies with larger cohorts are needed to validate these findings.Copyright © 2024 the Author(s). Published by Wolters Kluwer Health, Inc.

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