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Vesicovaginal Fistula Repair by Modified Martius Flap: A Step-by-Step Surgical Technique Video

  • Gynecologic Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript



Fistula repair in the perineal region represents a major challenge for surgeons. It is important for the medical community to facilitate and disclose these techniques.


The aim of this article was to show a stepwise approach for a direct repair and use of a Martius flap for a vesicovaginal fistula.


We show a single case performed in a patient who presented with a vesicovaginal fistula diagnosed after surgery, which did not respond to conservative management. The procedure consists of the following steps: intraoperative cystoscopy, anatomical direct repair of the fistulous tract between the bladder and vagina, and modified Martius flap.


Martius flap is a repair technique used for complex fistula in the perineal region. It is a simple, safe, and reproducible procedure with good long-term functional and esthetic results.

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The authors thank Laura Álvaro Valiente, MD, for the illustrations of this video.


This research did not receive any specific Grants from funding agencies in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations



TM: Conceptualization, video editing, writing the original draft. VL: Conceptualization, video recording, writing the original draft. PP: Conceptualization, review of the draft. LM: Conceptualization, review of the draft. SD: Conceptualization, project administration, surgery and video recording, supervision, review of the draft.

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Correspondence to Tiermes Marina MD.

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Marina, T., Lago, V., Padilla, P. et al. Vesicovaginal Fistula Repair by Modified Martius Flap: A Step-by-Step Surgical Technique Video. Ann Surg Oncol 28, 1002–1006 (2021).

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