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Urethrovaginal fistula closure.

Abstract：

INTRODUCTION AND HYPOTHESIS:In the developed world, urethrovaginal fistulas are most the likely the result of iatrogenic injury. These fistulas are quite rare. Proper surgical repair requires careful dissection and tension-free closure. The objective of this video is to demonstrate the identification and surgical correction of an urethrovaginal fistula. METHODS:The case presented is of a 59-year-old woman with a history of pelvic organ prolapse and symptomatic stress urinary incontinence who underwent vaginal hysterectomy, anterior colporrhaphy, posterior colporrhaphy, and synthetic sling placement. Postoperatively, she developed a mesh extrusion and underwent sling excision. After removal of her synthetic sling, she began to experience continuous urinary incontinence. Physical examination and cystourethroscopy demonstrated an urethrovaginal fistula at the midurethra. Options were discussed and the patient wished to undergo transvaginal fistula repair. RESULTS:The urethrovaginal fistula was intubated with a Foley catheter. The fistula tract was isolated and removed. The urethra was then closed with multiple tension-free layers. This video demonstrates several techniques for identifying and subsequently repairing an urethrovaginal fistula. Additionally, it demonstrates the importance of tension-free closure. CONCLUSIONS:Urethrovaginal fistulas are rare. They should be repaired with careful dissection and tension-free closure.

journal_name

Int Urogynecol J

journal_title

International urogynecology journal

authors

Clifton MM,Goldman HB

doi

10.1007/s00192-016-3111-8

subject

Has Abstract

pub_date

2017-01-01 00:00:00

pages

157-158

issue

1

eissn

0937-3462

issn

1433-3023

pii

10.1007/s00192-016-3111-8

journal_volume

28

pub_type

杂志文章

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