The use of human dura mater as an interposition graft in the treatment of vesicovaginal fistula

Alagöl, Bülent; Gözen, Ali Serdar; Kaya, Esat; İnci, Osman

doi:10.1023/b:urol.0000032682.84973.e9

Cited by 8 publications

(4 citation statements)

References 24 publications

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“…A mucosal segment from the unaffected portion of the bladder, about one-third larger than the defect to be covered, is dissected and attached with interrupted absorbable sutures, its luminal side facing the bladder lumen. Alternatively, human dura mater has been used successfully for the same purpose [16].…”

Section: Abdominal Repairmentioning

confidence: 99%

Complex obstetric fistulas

Genadry

Creanga

Roenneburg

et al. 2007

Intl J Gynecology & Obste

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Obstetric fistulas are rarely simple. Most patients in sub-Saharan Africa and parts of Asia are carriers of complex fistulas or complicated fistulas requiring expert skills for evaluation and management. A fistula is predictably complex when it is greater than 4 cm and involves the continence mechanism (the urethra is partially absent, the bladder capacity is reduced, or both); is associated with moderately severe scarring of the trigone and urethrovesical junction; and/or has multiple openings. A fistula is even more complicated when it is more than 6 cm in its largest dimension, particularly when it is associated with severe scarring and the absence of the urethra, and/or when it is combined with a recto-vaginal fistula. The present article reviews the evaluation methods and main surgical techniques used in the management of complex fistulas. The severity of the neurovascular alterations associated with these lesions, as well as inescapable limitations in staff, health facilities, and supplies, make their optimal management very challenging.

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Section: Abdominal Repairmentioning

confidence: 99%

Complex obstetric fistulas

Genadry

Creanga

Roenneburg

et al. 2007

Intl J Gynecology & Obste

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“…Vari tipi di tessuti di interposizione autologhi sono stati sperimentati. Oltre al classico flap di Martius sono stati utilizzati con successo flap peritoneali, flap omentali, flap di musculo gluteo, flap di muscolo retto dell'addome o di muscolo gracile, flap vaginali, flap di tessuto adiposo perisigmoideo, flap di dura madre umana (92–98).…”

Section: Discussioneunclassified

Repair of post-hysterectomy vesicovaginal fistulae: the state of the art

Giusti

Lisa

2015

Urologia

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In western countries, vesicovaginal fistulae (VVF) are mostly iatrogenic and in the majority of cases are secondary to hysterectomy. The golden standard for the treatment of VVF has remained largely unchanged since 1953 (Couvelaire): good visualization, good dissection, good approximation of the margins, and good urine drainage. However, several aspects are still being debated, including whether or not to pursue conservative repair, the timing for surgical repair, whether to perform excision of the fistula tract, the best type of surgical access, and whether or not to use tissue interposition. We decided to review the state of the art in the treatment of VVF, which are exclusively of a traumatic nature and non-radiated, by performing a bibliography search carried on Pubmed using keywords such as "vesicovaginal fistula". The search focused on recent articles and was largely restricted to the past 10 years.

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“…Similarly, rectus abdominis flaps, though also applicable for repair of vesicovaginal fistulas, have limited use because of the complicated operation procedure, long operation duration and abdominal wall trauma defect [15] . In addition, dura mater of the brain can be used as a filling material to repair vesicovaginal fistula, although there is the risk of craniotomy and dura mater of the brain having no vascular pedicle [16] .…”

Section: Discussionmentioning

confidence: 99%

Bulbocavernosus Muscle Flap for the Repair of Vesicovaginal Fistula

Bian²,

Lv³

2009

Urol Int

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Introduction: Anatomical studies on the bulbocavernosus muscle (BCM) and its supporting blood vessels were performed to explore the clinical roles of BCM flaps in the repair of complicated vesicovaginal fistulas. Methods: BCM and the supporting blood vessels of 15 female adult cadavers were anatomized. Pedicled BCM flaps were transposed to repair complicated vesicovaginal fistulas in 11 patients. Results: The left side of BCMs was 9.1 ± 1.8 cm in length and 1.5 ± 0.2 cm in width, whereas the right side was 9.0 ± 1.9 cm in length and 1.5 ± 0.4 cm in width. No significant difference between the two sides was identified (p > 0.05). The bulbocavernosus (BC) artery forms an angle with the superficial transverse perineal muscle at 64 ± 14° to the left and 68 ± 15° to the right. No significant difference between the two sides was found (p > 0.05). None of the 11 patients reported any postoperative urine leakage in the vagina or urinary incontinence. Follow-ups ranging from 6 months to 10 years found no urinary incontinence or urethral stricture; all patients have normal sexual function. Conclusion: Anatomical studies of BCM and its supporting blood vessels provide useful data for clinical application, especially the reduction of muscle flap death and the increase in the cure rate of complicated vesicovaginal fistulas.

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The use of human dura mater as an interposition graft in the treatment of vesicovaginal fistula

Abstract: The use of human dura mater as an interposition graft in the treatment of vesicovaginal fistula is an alternative for VVF repairs because of its excellent tissue compability, stability, good elasticity and absorbability.

Cited by 8 publications

References 24 publications

Complex obstetric fistulas

Complex obstetric fistulas

Repair of post-hysterectomy vesicovaginal fistulae: the state of the art

Bulbocavernosus Muscle Flap for the Repair of Vesicovaginal Fistula

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