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Management of neobladder-vaginal fistula and stress incontinence following radical cystectomy in women: a review.

Abstract：

:Contemporary literature regarding the management of neobladder-vaginal fistula and stress urinary incontinence following radical cystectomy and neobladder reconstruction in women is reviewed in this article. Neobladder-vaginal fistula is uncommon but mandates meticulous repair. Compared to the native bladder, the wall of the neobladder is much thinner that may render it vulnerable to fistulization. Preservation of the anterior vaginal wall during radical cystectomy decreases the likelihood of pouch-vaginal fistula. Omental flap interposition between the vaginal stump and neobladder at cystectomy may not always prevent fistulization if anterior vaginal wall is violated or overlapping suture lines are not avoided. Surgery for intractable stress incontinence following neobladder reconstruction is fraught with severe complications and requires judicious use of allograft pubovaginal slingplasty possibly with bone anchors. Martius flap interposition appears to play a crucial role in improving the outcome following transvaginal repair of the neobladder-vaginal fistula in multiple non-overlapping layers.

journal_name

World J Urol

journal_title

World journal of urology

authors

Tunuguntla HS,Manoharan M,Gousse AE

doi

10.1007/s00345-005-0013-7

keywords:

subject

Has Abstract

pub_date

2005-09-01 00:00:00

pages

231-5

issue

4

eissn

0724-4983

issn

1433-8726

journal_volume

23

pub_type

杂志文章,评审

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