New Laparoscopic Fistula Repair Technique Offers Highest Success Rate

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Atlanta Urogynecology Surgeons Perform Non-Invasive Technique with Less Down-Time

Drs. John R. Miklos and Robert D. Moore, leading experts in urogynecology and vaginal surgery, offer an advanced laparoscopic surgery to fix vesicovaginal fistulas in women. The procedure is minimally invasive and offers a higher success rate over other techniques.

A vesicovaginal fistula is a tear or hole that forms between the bladder and vagina. Fistulas tend to present themselves after any abdominal surgery, but are seen most frequently as a hysterectomy complication. This abnormality can also develop after childbirth, cancer operations or radiation therapy. Common factors that contribute to the formation of fistulas include diabetes or the regular use of tobacco or steroids.

Drs. Miklos and Moore have performed laparoscopic vesicovaginal fistula repairs over the past six years with great success and are two of the very few surgeons who use this approach. They receive referral patients from all over the country, many of whom have endured failed fistula repair surgeries in the past with other surgeons.

"The laparoscopic procedure success rate is greater than 90 percent," said Dr. Miklos. "Some of the patients we've treated have had more than three previous, but failed, attempts at fistula repair, but after one laparoscopic approach, they have been cured of their fistula and its symptoms."

Fistulas are commonly repaired through the vagina or abdomen; however, the vaginal approach is used more often because it offers a shorter recovery time for the patient. Unfortunately, the success of this procedure is not a guarantee. Drs. Miklos and Moore have discovered that the innovative technique via laparoscopy, in combination with the transvaginal approach, provides greater accuracy for fistula repair. Additionally, the procedure offers the shortest down-time and allows most patients to recover within 24 hours.

"Our laparoscopic procedure provides us with greater detail and complete visualization, creating a higher success rate for eliminating the problem once and for all," said Dr. Miklos. "There are also fewer complications associated with the laparoscopic approach."

Potential complications associated with vesicovaginal fistula repair include post operative failure, recurrent fistula formation, injury to ureter, bowel or intestines and vaginal shortening. The laparoscopic technique minimizes the risk of these complications.

Indications that a woman may be suffering from a fistula include painful or abnormal urination, continuous urinary incontinence or unusual vaginal discharge. Following a complete examination, a physician should be able to diagnose a fistula. However, X-rays may be required to reach an accurate diagnosis, as there may be more than one fistula and other organs may be involved as well.

About Drs. John R. Miklos and Robert D. Moore:
Drs. Miklos and Moore are internationally recognized experts in laparoscopic, urogynecologic and aesthetic reconstructive vagina surgery and are pioneers in minimally invasive vagina and bladder surgery techniques. Drs. Miklos and Moore have been in practice together for over eight years and have co-authored the book Vaginal Rejuvenation. Their practice, Atlanta Center for Laparoscopic Urogynecology, in business since 1997, is located in Alpharetta, Ga. They are Board certified by the American College of Obstetrics and Gynecology and fellows in good standing of the International Urogynecology Association. They are also members of American Association of Gynecologic Laparoscopists, the American Urologic Association and the American Urogynecology Society. Surgeries are performed at Northside Hospital in Atlanta. Individual biographies for Drs. Miklos and Moore and detailed information about their practice can be found at


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