Interposition flaps in transabdominal vesicovaginal fistula repairs: are they really necessary?

Evans, Deena; Madjar, Shahar; Politano, Víctor A.; Bejany, Darwich E.; Lynne, Charles M.; Gousse, Angelo E.

doi:10.1016/s0090-4295(01)00933-5

Cited by 92 publications

(65 citation statements)

References 15 publications

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“…We strongly agree with the hypothesis that the very first attempt of VVF repair has the highest chance of success; hence, interposition flaps should always be used to enhance the success rate [23]. Stents should be inserted in both the ureters prior to the lateral and superior mobilization and dissection of the bivalved bladder walls [16][17][18][19][20].…”

Section: Discussionsupporting

confidence: 78%

“…Vascularized interposition flaps are highly effective in reinforcing the suture lines. Various vascularized flaps have been described in literature [19][20][21][22][23][24][25][26]. The omentum is a well-vascularized tissue which prevents direct apposition of the suture lines, and its rich lymphatics enhance the extracellular fluid absorption from the area of surgery [19][20][21][22][23].…”

Section: Discussionmentioning

confidence: 99%

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Repair of vesicovaginal fistula by the transabdominal route: outcome at a north Indian tertiary hospital

et al. 2011

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Section: Discussionsupporting

confidence: 78%

Section: Discussionmentioning

confidence: 99%

Repair of vesicovaginal fistula by the transabdominal route: outcome at a north Indian tertiary hospital

et al. 2011

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“…The use of an omental flap between the suture lines, particularly when the surrounding tissues are not healthy and wellvascularized, seems to be important in achieving the best result. 17 In all of our cases, interposition of the omental flap was easily performed, and may have increased lymphatic drainage and vascularization of the area, promoting excellent surgical results.…”

Section: Discussionmentioning

confidence: 70%

Laparoscopic Repair of Vesicovaginal Fistula

Otsuka

Amaro²,

Tanaka³

et al. 2008

Journal of Endourology

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Purpose: Vesicovaginal fistula (VVF) is one of the most devastating surgical complications that can occur in women. The primary cause remains an abdominal hysterectomy. Approach to this condition can be transvaginal or transabdominal. Laparoscopic repair of VVF may be an alternative approach to this treating rare condition. We present seven cases of VVF treated with transperitoneal laparoscopic technique and our results.Methods: We retrospectively reviewed the charts of 7 women ranging from 37 to 74 years in age (mean age 52.

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“…Evans et al [17] recommended the interpositional flap even in simple fistula repair and claimed a 100% success rate. Tissue interposition is being extensively done in the repair of postradiation, giant or recurrent fistulae.…”

Section: Discussionmentioning

confidence: 99%

Our Experience with Genitourinary Fistulae

et al. 2009

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Introduction: Our objective was to analyze the incidence, etiopathology, diagnosis and therapeutic aspects of the genitourinary fistula in an Indian population. Methods: This is a retrospective analysis of the genitourinary fistulae repaired at the Department of Urology, Institute of Medical Sciences, Banaras Hindu University, between January 1990 and December 2006. The surgical approach varied in each patient. Interposition grafts or flaps were used as and when required. The main outcomes analyzed were the incidence, etiology, surgical approaches, accessory procedure required, need for tissue interposition, cure rate per repair and overall success rate. Results: Out of 558 cases, 403 were vesicovaginal, 84 ureterovaginal, 43 urethrovaginal and 28 vesicouterine fistulae. The most common etiology was obstructed labor (72.2%), followed by hysterectomy. The transvaginal route was preferred for repair wherever possible. The transabdominal route was adopted for the repair of supratrigonal vesicovaginal, ureterovaginal and vesicouterine fistulae and if bladder augmentation was required. Conservative management was successful in 1.9% of the vesicovaginal fistulae and in 8 cases of ureterovaginal fistula. The remaining cases were managed surgically with excellent results. Conclusion: Genitourinary fistulae are not life-threatening but are socially debilitating. Surgical repair provides the definitive cure, but expectant treatment can be tried in selective patients.

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Interposition flaps in transabdominal vesicovaginal fistula repairs: are they really necessary?

Cited by 92 publications

References 15 publications

Repair of vesicovaginal fistula by the transabdominal route: outcome at a north Indian tertiary hospital

Repair of vesicovaginal fistula by the transabdominal route: outcome at a north Indian tertiary hospital

Laparoscopic Repair of Vesicovaginal Fistula

Our Experience with Genitourinary Fistulae

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