Vesicovaginal Fistula Repair Using Amniotic Membrane Interposition: A Case Report

Abstract

Vesicovaginal fistula (VVF) is a debilitating condition associated with significant physical, psychological, and social morbidity. Surgical repair remains challenging because recurrence is often related to poor tissue quality and impaired wound healing. Human amniotic membrane (AM) possesses anti-inflammatory, anti-fibrotic, antimicrobial, and regenerative properties that may enhance tissue repair. We report the case of a 51-year-old woman who developed continuous urinary leakage following total hysterectomy for uterine fibroids. Clinical examination and cystoscopy revealed a 10-mm high vesicovaginal fistula located at the vaginal cuff. The patient underwent transabdominal surgical repair with interposition of an amniotic membrane patch obtained from a local tissue bank after donor screening and informed consent. The fistulous tract was excised, and the bladder and vaginal defects were closed separately using absorbable sutures with AM interposed between the repair layers. Postoperative recovery was uneventful, and the patient was discharged on postoperative day 4. At the two-week follow-up, she remained asymptomatic with no evidence of urinary leakage or fistula recurrence. This case suggests that amniotic membrane interposition may represent a safe and feasible adjunct in vesicovaginal fistula repair by promoting tissue healing and reducing recurrence risk. Further studies with larger patient populations and longer follow-up are needed to better define its role in reconstructive urologic surgery.