Skip to main content
Erschienen in: International Urogynecology Journal 7/2010

01.07.2010 | Original Article

Vaginal flap re-enforcement of vesico-vaginal fistula repair

verfasst von: Mohamed S. Shoukry, Mohamed E. Hassouna, Salah El-Salmy, Aly M. Abdel-Karim

Erschienen in: International Urogynecology Journal | Ausgabe 7/2010

Einloggen, um Zugang zu erhalten

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.
Literatur
1.
Zurück zum Zitat Zimmern PE, Hadley HR, Staskin DR, Raz S (1985) Genitourinary fistulae. Vaginal approach for repair of vesico-vaginal fistulae. Urol Clin North Am 12:361–367PubMed Zimmern PE, Hadley HR, Staskin DR, Raz S (1985) Genitourinary fistulae. Vaginal approach for repair of vesico-vaginal fistulae. Urol Clin North Am 12:361–367PubMed
2.
3.
Zurück zum Zitat Couvelaire R (1953) Reflections on a personal statistics of 136 vesicovaginal fistulas. J Urol Medicale Chir 59:150–160PubMed Couvelaire R (1953) Reflections on a personal statistics of 136 vesicovaginal fistulas. J Urol Medicale Chir 59:150–160PubMed
4.
Zurück zum Zitat 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):295–304CrossRefPubMed 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):295–304CrossRefPubMed
5.
Zurück zum Zitat 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):372–376CrossRefPubMed 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):372–376CrossRefPubMed
6.
Zurück zum Zitat Persky L, Herman G, Guerrier K (1979) Non-delay in vesicovaginal fistula repair. Urology 13:273–275CrossRefPubMed Persky L, Herman G, Guerrier K (1979) Non-delay in vesicovaginal fistula repair. Urology 13:273–275CrossRefPubMed
7.
Zurück zum Zitat Cruikshank SH (1988) Early closure of post hysterectomy vesicovaginal fistulas. South Med J 81:1525–1528PubMed Cruikshank SH (1988) Early closure of post hysterectomy vesicovaginal fistulas. South Med J 81:1525–1528PubMed
8.
Zurück zum Zitat Raz S, Bregg KJ, Nitti VW, Sussman E (1993) Transvaginal repair of vesicovaginal fistula using a peritoneal flap. J Urol 150:56–59PubMed Raz S, Bregg KJ, Nitti VW, Sussman E (1993) Transvaginal repair of vesicovaginal fistula using a peritoneal flap. J Urol 150:56–59PubMed
9.
Zurück zum Zitat Tancer ML (1980) The post-total hysterectomy (vault) vesicovaginal fistula. J Urol 123:839–840PubMed Tancer ML (1980) The post-total hysterectomy (vault) vesicovaginal fistula. J Urol 123:839–840PubMed
10.
Zurück zum Zitat Wein AJ, Malloy TR, Carpiniello VL, Greenberg SH, Murphy J (1980) Repair of vesicovaginal fistula by a suprapubic transvesical approach. Surg Gynecol Obstet 150:57–60PubMed Wein AJ, Malloy TR, Carpiniello VL, Greenberg SH, Murphy J (1980) Repair of vesicovaginal fistula by a suprapubic transvesical approach. Surg Gynecol Obstet 150:57–60PubMed
11.
Zurück zum Zitat Goh JTW (2004) A new classification for female genital tract fistula. ANZJOG 44:502–504PubMed Goh JTW (2004) A new classification for female genital tract fistula. ANZJOG 44:502–504PubMed
12.
Zurück zum Zitat O'Conor VJ Jr (1980) Review of experience with vesicovaginal fistula repair. J Urol 123:367–369PubMed O'Conor VJ Jr (1980) Review of experience with vesicovaginal fistula repair. J Urol 123:367–369PubMed
13.
Zurück zum Zitat Iselin CE, Aslan P, Webster GD (1998) Transvaginal repair of vesicovaginal fistulas after hysterectomy by vaginal cuff excision. J Urol 160:728–730CrossRefPubMed Iselin CE, Aslan P, Webster GD (1998) Transvaginal repair of vesicovaginal fistulas after hysterectomy by vaginal cuff excision. J Urol 160:728–730CrossRefPubMed
14.
Zurück zum Zitat Sims JM (1852) On the treatment of vesicovaginal fistula. Am J Med Sci 23:59–64CrossRef Sims JM (1852) On the treatment of vesicovaginal fistula. Am J Med Sci 23:59–64CrossRef
15.
Zurück zum Zitat Martius H (1928) Die operative Wiederherstellung der vollkommen fehlenden Harnrohre und des Schliessmuskels derselben. Zentralbl Gynakol 52:480–485 Martius H (1928) Die operative Wiederherstellung der vollkommen fehlenden Harnrohre und des Schliessmuskels derselben. Zentralbl Gynakol 52:480–485
16.
Zurück zum Zitat Hilton P (2001) Vesicovaginal fistula: new perspectives. Curr Opin Obstet Gynecol 13:513–520CrossRefPubMed Hilton P (2001) Vesicovaginal fistula: new perspectives. Curr Opin Obstet Gynecol 13:513–520CrossRefPubMed
17.
Zurück zum Zitat McKay HA (2004) Vesicovaginal fistula repair: transurethral suture cystorrhaphy as a minimally invasive alternative. J Endourol 18:487–490CrossRefPubMed McKay HA (2004) Vesicovaginal fistula repair: transurethral suture cystorrhaphy as a minimally invasive alternative. J Endourol 18:487–490CrossRefPubMed
18.
Zurück zum Zitat Leach GE, Raz S (1983) Vaginal flap technique: a method of transvaginal vesicovaginal fistula repair. Female urology. WB Saunders Co, Philadelphia, pp 372–377 Leach GE, Raz S (1983) Vaginal flap technique: a method of transvaginal vesicovaginal fistula repair. Female urology. WB Saunders Co, Philadelphia, pp 372–377
19.
Zurück zum Zitat 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):670–674CrossRefPubMed 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):670–674CrossRefPubMed
20.
Zurück zum Zitat 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):1033–1036CrossRefPubMed 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):1033–1036CrossRefPubMed
21.
Zurück zum Zitat 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):259–263CrossRefPubMed 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):259–263CrossRefPubMed
22.
Zurück zum Zitat Kanaoka Y, Hirai K, Ishiko O, Ogita S (2001) Vesicovaginal fistula treated with fibrin glue. Int J Gynaecol Obstet 73:147–149CrossRefPubMed Kanaoka Y, Hirai K, Ishiko O, Ogita S (2001) Vesicovaginal fistula treated with fibrin glue. Int J Gynaecol Obstet 73:147–149CrossRefPubMed
23.
Zurück zum Zitat Robles JE, Saiz A, Rioja J, Brugarolas X, Berian JM (2009) Collagen graft interposition in vesicovaginal fistula treatment. Urol Int 82(1):116–118CrossRefPubMed Robles JE, Saiz A, Rioja J, Brugarolas X, Berian JM (2009) Collagen graft interposition in vesicovaginal fistula treatment. Urol Int 82(1):116–118CrossRefPubMed
24.
Zurück zum Zitat 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):1119–1123CrossRefPubMed 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):1119–1123CrossRefPubMed
Metadaten
Titel
Vaginal flap re-enforcement of vesico-vaginal fistula repair
verfasst von
Mohamed S. Shoukry
Mohamed E. Hassouna
Salah El-Salmy
Aly M. Abdel-Karim
Publikationsdatum
01.07.2010
Verlag
Springer-Verlag
Erschienen in
International Urogynecology Journal / Ausgabe 7/2010
Print ISSN: 0937-3462
Elektronische ISSN: 1433-3023
DOI
https://doi.org/10.1007/s00192-010-1124-2

Weitere Artikel der Ausgabe 7/2010

International Urogynecology Journal 7/2010 Zur Ausgabe

Update Gynäkologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert – ganz bequem per eMail.