Vesicovaginal fistula (VVF) is a fistulous tract between the bladder and the vagina, leading to continuous involuntary leakage of urine into the vagina. The treatment of VVF is a surgical challenge, options starting from minimal to maximally invasive which have evolved over the past two centuries and are still evolving. The small VVFs, which occur following failure of conservative management and secondary to failure of primary repair, are a formidable challenge to the treating surgeon. We hereby present our long-term experience of treating this subset of patients with our minimally invasive approach of laser welding

We did a retrospective analysis of all patients who underwent laser welding for the management of vesicovaginal fistula between January 1, 2001 and May 2024, in Department of urology, AIIMS New Delhi.

Total of19 patients underwent laser welding of vesicovaginal fistula. The mean age was 45 years. The VVF were primary (failing to heal following conservative management) in most of the cases. The mean fistula size was 3 mm (range, 2–5mm). Neodymium yttrium aluminium garnet (YAG) laser was used for the initial case, and in the remaining all cases, holmium YAG laser was used for circumferential welding of the fistula. In 3 cases sealent glue was also used in addition to LaSser welding. Following the procedure, a catheter was kept for 3 weeks along with anticholinergics. The mean hospitalisation period was 2 days.Our series showed a success rate of 65%. Most patients remain dry with improved quality of life at 1 year follow up

Laser welding of VVF is a simple, safe, successful and efficacious minimally invasive procedure in a select group of patients. (Small fistula with oblique tract with no underlying pathologies like malignancy and radiation cystitis.)