Skip to main content

Advertisement

SpringerLink
Log in

Vaginal flap re-enforcement of vesico-vaginal fistula repair

  • Original Article
  • Published:
International Urogynecology Journal Aims and scope Submit manuscript

Abstract

Introduction and hypothesis

Vesicovaginal fistula (VVF) is a distressing urologic disorder. We describe a new technique that adds a third layer of closure during vaginal repair of VVF.

Methods

Twenty female patients with low VVF were included. A circumferential incision was made around the fistula that was completely excised. A rectangular vaginal flap was created just proximal to the site of the fistula. After closure of the urinary bladder, the distal edges of the vaginal flap were dissected and it was mobilized and interposed between the bladder and the vagina. Then the vagina was closed.

Results

The mean follow-up was 16 ± 9 months. All of the patients are dry. None of them had any added morbidity due to the procedure. There are no postoperative complications.

Conclusions

Vaginal flap reinforcement during vaginal repair of VVF is a simple and effective technique with high success rate and no added complications.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

Abbreviations

VVF:

Vesicovaginal fistula

References

  1. Zimmern PE, Hadley HR, Staskin DR, Raz S (1985) Genitourinary fistulae. Vaginal approach for repair of vesico-vaginal fistulae. Urol Clin North Am 12:361–367

    CAS  PubMed  Google Scholar 

  2. Carr LK, Webster GD (1996) Abdominal repair of vesicovaginal fistula. Urology 48:10–11

    Article  CAS  PubMed  Google Scholar 

  3. Couvelaire R (1953) Reflections on a personal statistics of 136 vesicovaginal fistulas. J Urol Medicale Chir 59:150–160

    CAS  PubMed  Google Scholar 

  4. Angioli R, Penalver M, Muzii L, Mendez L, Mirhashemi R, Bellati F, Crocè C, Panici PB (2003) Guidelines of how to manage vesicovaginal fistula. Crit Rev Oncol Hematol 48(3):295–304

    Article  PubMed  Google Scholar 

  5. Kapoor R, Ansari MS, Singh P, Gupta P, Khurana N, Mandhani A et al (2007) Management of vesicovaginal fistula: an experience of 52 cases with a rationalized algorithm for choosing the transvaginal or transabdominal approach. Indian J Urol 23(4):372–376

    Article  PubMed  Google Scholar 

  6. Persky L, Herman G, Guerrier K (1979) Non-delay in vesicovaginal fistula repair. Urology 13:273–275

    Article  CAS  PubMed  Google Scholar 

  7. Cruikshank SH (1988) Early closure of post hysterectomy vesicovaginal fistulas. South Med J 81:1525–1528

    CAS  PubMed  Google Scholar 

  8. Raz S, Bregg KJ, Nitti VW, Sussman E (1993) Transvaginal repair of vesicovaginal fistula using a peritoneal flap. J Urol 150:56–59

    CAS  PubMed  Google Scholar 

  9. Tancer ML (1980) The post-total hysterectomy (vault) vesicovaginal fistula. J Urol 123:839–840

    CAS  PubMed  Google Scholar 

  10. Wein AJ, Malloy TR, Carpiniello VL, Greenberg SH, Murphy J (1980) Repair of vesicovaginal fistula by a suprapubic transvesical approach. Surg Gynecol Obstet 150:57–60

    CAS  PubMed  Google Scholar 

  11. Goh JTW (2004) A new classification for female genital tract fistula. ANZJOG 44:502–504

    PubMed  Google Scholar 

  12. O'Conor VJ Jr (1980) Review of experience with vesicovaginal fistula repair. J Urol 123:367–369

    PubMed  Google Scholar 

  13. Iselin CE, Aslan P, Webster GD (1998) Transvaginal repair of vesicovaginal fistulas after hysterectomy by vaginal cuff excision. J Urol 160:728–730

    Article  CAS  PubMed  Google Scholar 

  14. Sims JM (1852) On the treatment of vesicovaginal fistula. Am J Med Sci 23:59–64

    Article  Google Scholar 

  15. Martius H (1928) Die operative Wiederherstellung der vollkommen fehlenden Harnrohre und des Schliessmuskels derselben. Zentralbl Gynakol 52:480–485

    Google Scholar 

  16. Hilton P (2001) Vesicovaginal fistula: new perspectives. Curr Opin Obstet Gynecol 13:513–520

    Article  CAS  PubMed  Google Scholar 

  17. McKay HA (2004) Vesicovaginal fistula repair: transurethral suture cystorrhaphy as a minimally invasive alternative. J Endourol 18:487–490

    Article  PubMed  Google Scholar 

  18. Leach GE, Raz S (1983) Vaginal flap technique: a method of transvaginal vesicovaginal fistula repair. Female urology. WB Saunders Co, Philadelphia, pp 372–377

    Google Scholar 

  19. Evans DH, Madjar S, Politano VA, Bejany DE, Lynne CM, Gousse AE (2001) Interposition flaps in transabdominal vesicovaginal fistula repairs: are they really necessary? Urology 57(4):670–674

    Article  CAS  PubMed  Google Scholar 

  20. Eilber KS, Kavaler E, Rodríguez LV, Rosenblum N, Raz S (2003) Ten-year experience with transvaginal vesicovaginal fistula repair using tissue interposition. J Urol 169(3):1033–1036

    Article  PubMed  Google Scholar 

  21. Rangnekar NP, Imdad Ali N, Kaul SA, Pathak HR (2000) Role of the martius procedure in the management of urinary-vaginal fistulas. J Am Coll Surg 191(3):259–263

    Article  CAS  PubMed  Google Scholar 

  22. Kanaoka Y, Hirai K, Ishiko O, Ogita S (2001) Vesicovaginal fistula treated with fibrin glue. Int J Gynaecol Obstet 73:147–149

    Article  CAS  PubMed  Google Scholar 

  23. Robles JE, Saiz A, Rioja J, Brugarolas X, Berian JM (2009) Collagen graft interposition in vesicovaginal fistula treatment. Urol Int 82(1):116–118

    Article  CAS  PubMed  Google Scholar 

  24. Reynolds WS, Gottlieb LJ, Lucioni A, Rapp DE, Song DH, Bales GT (2008) Vesicovaginal fistula repair with rectus abdominus myofascial interposition flap. Urology 71(6):1119–1123

    Article  PubMed  Google Scholar 

Download references

Source of funding:

None

Conflicts of interest

None

Author information

Authors and Affiliations

  1. Department of Urology, Faculty of Medicine, Alexandria University, 12 Ahmed Basha Zol-Fokar St, #903, Louran, Alexandria, Egypt

    Mohamed S. Shoukry, Mohamed E. Hassouna, Salah El-Salmy & Aly M. Abdel-Karim

Authors
  1. Mohamed S. Shoukry
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Mohamed E. Hassouna
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Salah El-Salmy
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Aly M. Abdel-Karim
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Aly M. Abdel-Karim.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Shoukry, M.S., Hassouna, M.E., El-Salmy, S. et al. Vaginal flap re-enforcement of vesico-vaginal fistula repair. Int Urogynecol J 21, 829–833 (2010). https://doi.org/10.1007/s00192-010-1124-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00192-010-1124-2

Keywords

Search

Navigation