Abstract：
INTRODUCTION AND HYPOTHESIS:Circumferential vesicourethrovaginal fistula is a severe form of obstetric injury that is challenging to repair and carries a poor prognosis related to eventual continence. Here, we report the successful repair of a circumferential vesicovaginal fistula associated with near total loss of the urethra. The use the anterior bladder flap technique along with an autologous rectus sheath sling resulted in the creation of an effective continence unit. METHODS:A 31-year-old woman had a history of obstructed labor resulting in intrauterine death followed by trans-abdominal hysterectomy for postpartum hemorrhage. Since then she had had total urinary incontinence. She had an attempted repair through the vaginal route, which had failed. Physical examination and endoscopic evaluation revealed a large vesicourethrovaginal fistula with near total loss of the urethra leaving only the meatus. Intraoperatively, we found that it was a large circumferential defect in the infratrigonal region with no anterior bladder wall left at the site of the fistula. RESULTS:We performed an anterior bladder flap procedure as described by Tanagho along with an autologous rectus sheath sling for additional support. Postoperatively, the patient was completely continent. CONCLUSIONS:The anterior bladder onlay flap technique, which has been used extensively for female urethral reconstruction in developed countries, along with an autologous rectus sheath sling is an effective technique for management of circumferential fistulas allowing good continence. Incorporation of this technique into the armamentarium of surgeons managing fistulas in developing countries will go a long way toward helping this unfortunate group of women with this morbid complication of obstructed labor.
journal_name
Int Urogynecol Jjournal_title
International urogynecology journalauthors
Ashwin Shekar P,Dumra A,Pal BC,Gopalakrishnan Gdoi
10.1007/s00192-020-04398-ysubject
Has Abstractpub_date
2020-06-23 00:00:00eissn
0937-3462issn
1433-3023pii
10.1007/s00192-020-04398-ypub_type
杂志文章abstract：OBJECTIVE:Our aim was to identify drivers of and barriers to help-seeking behaviour of older women with pelvic floor dysfunction (PFD) living independently in Australia . METHODS:Women aged ≥55 years were recruited to this cross-sectional study during July and August 2016. Bladder, bowel, pelvic organ prolapse (POP) a...
journal_title：International urogynecology journal
pub_type： 杂志文章
doi：10.1007/s00192-018-3618-2
更新日期：2018-11-01 00:00:00
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journal_title：International urogynecology journal
pub_type： 杂志文章
doi：10.1007/s00192-019-03936-7
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journal_title：International urogynecology journal
pub_type： 杂志文章,随机对照试验
doi：10.1007/s00192-015-2666-0
更新日期：2015-08-01 00:00:00
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journal_title：International urogynecology journal
pub_type： 杂志文章
doi：10.1007/s00192-012-1849-1
更新日期：2013-04-01 00:00:00
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journal_title：International urogynecology journal
pub_type： 杂志文章
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更新日期：2020-02-01 00:00:00
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journal_title：International urogynecology journal
pub_type： 杂志文章
doi：10.1007/s00192-013-2156-1
更新日期：2014-01-01 00:00:00
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journal_title：International urogynecology journal
pub_type： 杂志文章,随机对照试验
doi：10.1007/s00192-011-1511-3
更新日期：2011-10-01 00:00:00
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journal_title：International urogynecology journal
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journal_title：International urogynecology journal
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journal_title：International urogynecology journal
pub_type： 杂志文章
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journal_title：International urogynecology journal
pub_type： 杂志文章,随机对照试验
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更新日期：2015-08-01 00:00:00
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pub_type： 杂志文章
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更新日期：2020-01-01 00:00:00
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pub_type： 杂志文章
doi：10.1007/s00192-018-3761-9
更新日期：2019-08-01 00:00:00
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pub_type： 杂志文章
doi：10.1007/s00192-020-04497-w
更新日期：2021-01-01 00:00:00
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journal_title：International urogynecology journal
pub_type： 杂志文章
doi：10.1007/s00192-017-3551-9
更新日期：2018-09-01 00:00:00
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journal_title：International urogynecology journal
pub_type： 杂志文章
doi：10.1007/s00192-011-1506-0
更新日期：2011-10-01 00:00:00
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journal_title：International urogynecology journal
pub_type： 杂志文章
doi：10.1007/s00192-017-3472-7
更新日期：2018-07-01 00:00:00
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journal_title：International urogynecology journal
pub_type： 临床试验,杂志文章
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pub_type： 杂志文章
doi：10.1007/s00192-017-3267-x
更新日期：2017-08-01 00:00:00
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journal_title：International urogynecology journal
pub_type： 杂志文章
doi：10.1007/s00192-015-2776-8
更新日期：2015-12-01 00:00:00
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journal_title：International urogynecology journal
pub_type： 杂志文章
doi：10.1007/s00192-020-04436-9
更新日期：2020-07-18 00:00:00
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journal_title：International urogynecology journal
pub_type： 杂志文章
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更新日期：2014-11-01 00:00:00
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journal_title：International urogynecology journal
pub_type： 杂志文章,多中心研究
doi：10.1007/s00192-017-3364-x
更新日期：2018-01-01 00:00:00
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journal_title：International urogynecology journal
pub_type： 杂志文章,多中心研究,随机对照试验
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更新日期：2019-04-01 00:00:00
abstract：INTRODUCTION AND HYPOTHESIS:Minimally invasive sacral colpopexy has increased over the past decade, with many senior physicians adopting this new skill set. However, skill acquisition at an academic institution in the presence of postgraduate learners is not well described. This manuscript outlines the introduction of ...
journal_title：International urogynecology journal
pub_type： 杂志文章
doi：10.1007/s00192-013-2085-z
更新日期：2013-11-01 00:00:00
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journal_title：International urogynecology journal
pub_type： 杂志文章
doi：10.1007/s00192-019-04215-1
更新日期：2020-09-01 00:00:00
abstract：INTRODUCTION AND HYPOTHESIS:The purpose of this study was to apply a human factors research approach to identify flow disruptions, deviations in the optimal course of care, in robotic abdominal sacrocolpopexy procedures with the ultimate goal of developing system interventions to improve the safety and efficiency of ro...
journal_title：International urogynecology journal
pub_type： 杂志文章
doi：10.1007/s00192-019-03929-6
更新日期：2019-12-01 00:00:00
abstract：INTRODUCTION AND HYPOTHESIS:In order to assess the outcome following surgery for urinary incontinence (UI) and pelvic organ prolapse (POP) the importance of patient-reported outcome measures, in addition to the clinical objective measures, has been recognised. The International Consultation on Incontinence has initiate...
journal_title：International urogynecology journal
pub_type： 杂志文章
doi：10.1007/s00192-015-2840-4
更新日期：2016-04-01 00:00:00
