International Urogynecology Journal

, Volume 27, Issue 12, pp 1925–1927 | Cite as

Transvaginal repair of a urethrovaginal fistula using the Latzko technique with a bulbocavernosus (Martius) flap

  • Ariel ZilberlichtEmail author
  • Yuval Lavy
  • Ron Auslender
  • Yoram Abramov
IUJ Video


Introduction and hypothesis

Urethrovaginal fistula is a rare disorder that may occur following sling procedures for stress urinary incontinence, excision of a urethral diverticulum, anterior vaginal wall repair, radiation therapy, and prolonged indwelling urethral catheter. The most common clinical manifestation is continuous urinary leakage through the vagina, aggravated by an increase in the intra-abdominal pressure. Appropriate management, including timing of the surgical intervention and the preferred technique, remains controversial.


This video presentation describes the transvaginal repair of a urethrovaginal fistula using the Latzko technique and a bulbocavernosus (Martius) flap.


The patient’s postoperative course was uneventful. At her follow-up visit 2 months later, she was free of urinary leakage, and a pelvic examination revealed excellent healing, with complete closure of the fistula.


Transvaginal repair using the Latzko technique with a vascular bulbocavernosus (Martius) flap is an effective and safe mode of treatment.


Latzko technique Bulbocavernosus (Martius) flap Urethrovaginal fistula 


Compliance with ethical standards

Financial disclaimer/conflicts of interest



Written informed consent was obtained from the patient for publication of this video article and any accompanying images.

Supplementary material


(MP4 92284 kb)


  1. 1.
    Estevez JP, Cosson M, Boukerrou M (2010) An uncommon case of urethrovaginal fistula resulting from tension-free vaginal tape. Int Urogynecol J 21(7):889–891. doi: 10.1007/s00192-009-1067-7 CrossRefPubMedGoogle Scholar
  2. 2.
    Lo ALD (2014) Urethrovaginal fistula: a rare complication of transurethral catheterization. Female Pelvic Med Reconstruct Surg 20(5):293–294. doi: 10.1097/spv.0000000000000054 CrossRefGoogle Scholar
  3. 3.
    Sinclair AJ, Ramsay IN (2011) The psychosocial impact of urinary incontinence in women. Obstet Gynaecol 13:143–148CrossRefGoogle Scholar
  4. 4.
    Baskin D, Tatlidede S, Karsidag SH (2005) Martius repair in urethrovaginal defects. J Pediatr Surg 40(9):1489–1491. doi: 10.1016/j.jpedsurg.2005.05.054 CrossRefPubMedGoogle Scholar
  5. 5.
    Leng WW, Amundsen CL, McGuire EJ (1998) Management of female genitourinary fistulas: transvesical or transvaginal approach? J Urol 160(6 Pt 1):1995–1999PubMedGoogle Scholar
  6. 6.
    Pushkar DY, Dyakov VV, Kosko JW, Kasyan GR (2006) Management of urethrovaginal fistulas. Eur Urol 50(5):1000–1005. doi: 10.1016/j.eururo.2006.08.002 CrossRefPubMedGoogle Scholar
  7. 7.
    Melah GS, El-Nafaty AU, Bukar M (2006) Early versus late closure of vesicovaginal fistulas. Int J Gynaecol Obstet 93(3):252–253. doi: 10.1016/j.ijgo.2006.02.017 CrossRefPubMedGoogle Scholar
  8. 8.
    Flisser AJ, Blaivas JG (2003) Outcome of urethral reconstructive surgery in a series of 74 women. J Urol 169(6):2246–2249. doi: 10.1097/01.ju.0000061763.88247.16 CrossRefPubMedGoogle Scholar
  9. 9.
    Latzko W (1942) Postoperative vesicovaginal fistulas: genesis and therapy. Am J Surg 58(2):211–228CrossRefGoogle Scholar
  10. 10.
    Martius H (1928) Die operative Wiederherstellung der vollkommen fehlenden Harnröhre und des Schiessmuskels derselben. Zentralbl Gynakol 52:480Google Scholar

Copyright information

© The International Urogynecological Association 2016

Authors and Affiliations

  • Ariel Zilberlicht
    • 1
    Email author
  • Yuval Lavy
    • 2
  • Ron Auslender
    • 1
  • Yoram Abramov
    • 1
  1. 1.Division of Urogynecology and Reconstructive Pelvic Surgery, Department of Obstetrics and Gynecology, Carmel Medical Center, Rappaport Faculty of MedicineTechnion UniversityHaifaIsrael
  2. 2.Department of Obstetrics and GynecologyHadassah Hebrew University Medical CenterJerusalemIsrael

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