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


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.

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  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

    Article  PubMed  Google 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

    Article  Google Scholar 

  3. 3.

    Sinclair AJ, Ramsay IN (2011) The psychosocial impact of urinary incontinence in women. Obstet Gynaecol 13:143–148

    Article  Google 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

    Article  PubMed  Google 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):1995–1999

    CAS  PubMed  Google 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

    Article  PubMed  Google 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

    CAS  Article  PubMed  Google 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

    Article  PubMed  Google Scholar 

  9. 9.

    Latzko W (1942) Postoperative vesicovaginal fistulas: genesis and therapy. Am J Surg 58(2):211–228

    Article  Google Scholar 

  10. 10.

    Martius H (1928) Die operative Wiederherstellung der vollkommen fehlenden Harnröhre und des Schiessmuskels derselben. Zentralbl Gynakol 52:480

    Google Scholar 

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Correspondence to Ariel Zilberlicht.

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

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Zilberlicht, A., Lavy, Y., Auslender, R. et al. Transvaginal repair of a urethrovaginal fistula using the Latzko technique with a bulbocavernosus (Martius) flap. Int Urogynecol J 27, 1925–1927 (2016).

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  • Latzko technique
  • Bulbocavernosus (Martius) flap
  • Urethrovaginal fistula