Application of Small Intestinal Submucosa Graft for Repair of Complicated Vesicovaginal Fistula: A Pilot Study

Farahat, Yasser; Elbendary, Mohamed; El‐Gamal, Osama M.; Tawfik, Ahmad M.; Bastawisy, Mohamed; Radwan, Mohamed; Rasheed, Mohamed

doi:10.1016/j.juro.2012.05.019

Cited by 17 publications

(10 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…However the greater omentum or Martius flaps are often readily accessible during abdominal or vaginal repair and can provide an adjunct to the principles of contemporary fistulae surgery, namely non-overlapping suture lines. A variety of alternative biological grafts and synthetic materials have been investigated in this context, namely porcine small intestinal submucosa [16] , FloSeal haemostatic matrix [15] , and fibrin glue [20] . However, it is likely that even in the absence of suitable quantities of omentum or labial fat, appropriate tissue interposition can be achieved with peritoneum, labial skin, or even autologous bladder mucosa flaps without a significant increase in morbidity [21] , [22] .…”

Section: Discussionmentioning

confidence: 99%

“…Farahat et al. [16] investigated the use of de-cellularised porcine small intestinal mucosa as an interposition graft during both trans-vaginal and trans-abdominal repairs. Overall success rates were 91.3% after 6 months of follow-up, with all of the seven patients undergoing a trans-vaginal repair and 14 out of the 16 undergoing an abdominal repair demonstrating successful closure.…”

Section: Fistula Managementmentioning

confidence: 99%

See 1 more Smart Citation

The choice of surgical approach in the treatment of vesico-vaginal fistulae

Hillary

Chapple

2018

Asian Journal of Urology

View full text Add to dashboard Cite

Vesico-vaginal fistula is a global healthcare problem that has a high prevalence in sub-Saharan Africa, where obstetric complications lead to the development of this condition. Despite this, comparatively few fistula repairs are performed in well-resourced countries, where iatrogenic injury is the leading aetiological factor. As a consequence, much of our knowledge results from the experience of relatively few fistula surgeons in areas of high prevalence borne out of large case series or retrospective cohorts rather than high level evidence. At present, debate surrounds the exact timing of repair and the most appropriate surgical approach for this condition. Certain fistulae can be selected for conservative management, while those that do not demonstrate factors associated with spontaneous closure can be selected for surgery. Fistula surgeons should be aware of several potential repair options and the principles of contemporary fistula surgery, as the first attempt at repair is likely to be the best opportunity to achieve a successful outcome. We review the available literature and provide evidence on the optimal timing of repair, the appropriate surgical approach and the use of tissue interpositioning in fistula surgery.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Fistula Managementmentioning

confidence: 99%

The choice of surgical approach in the treatment of vesico-vaginal fistulae

Hillary

Chapple

2018

Asian Journal of Urology

View full text Add to dashboard Cite

show abstract

“…Labial fibrofatty tissue (Martius flap), peritoneum, omentum, gluteus muscle, rectus abdominis muscle, gracilis muscle, small intestinal submucosa, human dura grafts, sigmoid epiploicae, and urachus are some of the tissues described for interposition. [49505152535455]…”

Section: The Principles Of Vesicovaginal Fistula Repairmentioning

confidence: 99%

Vesicovaginal fistula: Review and recent trends

Rajaian¹,

Murugavaithianathan²,

Panda³

2019

Indian J Urol

View full text Add to dashboard Cite

Vesicovaginal fistula (VVF) is an abnormal communication between the bladder and the vagina. Prompt diagnosis and timely repair are essential for successful management of these cases. As the clinical scenario is variable, it is difficult to frame uniform guidelines for the management of VVF. Hence, the management protocol is dependent on the treating surgeon and the available resources. Conservative methods should be used in carefully selected patients. Delayed repair is better than the early repair of VVF. Transvaginal route for repair is preferred as it has low morbidity, higher success rates, and minimal complications. Anticholinergics should be used in the postoperative period for better chance of bladder healing. When facilities are available, all the patients may be referred to a tertiary care center where expertise and advanced resources are available. Trained surgeons adapting the new trends should refine the art of VVF repair.

show abstract

“…Graft interposition is indicated in cases of recurrent, RT-induced, and long-standing VVFs [35]. A variety of grafts have been used in abdominal repairs including omentum and peritoneum covering the bladder dome [36]. When operating transvaginally, the peritoneal reflection of the culde-sac or the more popular Martius bulbocavernosus muscle/fat graft may be interposed between the bladder and vagina to help prevent re-fistulisation [37].…”

Section: Graft Interpositionmentioning

confidence: 99%

Update on vesicovaginal fistula: A systematic review

Elazab

Abolella

Farouk

2019

Arab Journal of Urology

View full text Add to dashboard Cite

Objective: To conduct a systematic review of the literature on vesicovaginal fistula (VVF), including reporting on the aetiology, in both developed and underdeveloped countries; diagnosis; intraoperative prevention; and management. Methods: We conducted a systematic review of the literature on VVF through the PubMed and the Cochrane Library according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. The search was conducted from 1985 to 2018 in English, using the keywords 'fistula' and 'vesicovaginal fistula'. Prospective studies were preferred; however, retrospective studies and case reports were used when no prospective studies were available. All authors' extracted relevant data related to the proposed review of VVF and carefully examined collected articles. Results: In all, 116 relevant articles were identified and 43 articles were included in this systematic review. The outcome of surgical reconstruction was >90%, but the outcome may be suboptimal in radiotherapy (RT)-induced VVFs. Absolute indications for an abdominal approach included: ureteric involvement, the need for concomitant bladder augmentation, severe vaginal stenosis, and an inability to tolerate the dorsal lithotomy position (e.g. due to muscular spasticity). Typically, it was recommended to wait at least 3 months to allow the inflammatory response to subside before definitive surgery. Early fistula repair can be performed in the absence of infection and in patients who have not received pelvic RT. Conclusion: VVF is rare in developed countries. Surgical treatment is the primary method of repair. The outcome of surgical reconstruction exceeds 90%, but the outcome may be suboptimal in RT-induced VVFs.

show abstract

Application of Small Intestinal Submucosa Graft for Repair of Complicated Vesicovaginal Fistula: A Pilot Study

Abstract: Using small intestinal submucosa as an interposition layer at anatomical vaginal and/or transabdominal repair of complicated vesicovaginal fistulas seems to be a simple, feasible solution.

Cited by 17 publications

References 25 publications

The choice of surgical approach in the treatment of vesico-vaginal fistulae

The choice of surgical approach in the treatment of vesico-vaginal fistulae

Vesicovaginal fistula: Review and recent trends

Update on vesicovaginal fistula: A systematic review

Contact Info

Product

Resources

About