Tiermes Marina1, Víctor Lago2, Pablo Padilla2, Luis Matute2, Santiago Domingo2. 1. Department of Gynecologic Oncology, University Hospital La Fe, Valencia, Spain. tiermesm@gmail.com. 2. Department of Gynecologic Oncology, University Hospital La Fe, Valencia, Spain.
Abstract
BACKGROUND: Fistula repair in the perineal region represents a major challenge for surgeons. It is important for the medical community to facilitate and disclose these techniques. OBJECTIVE: The aim of this article was to show a stepwise approach for a direct repair and use of a Martius flap for a vesicovaginal fistula. METHODS: We show a single case performed in a patient who presented with a vesicovaginal fistula diagnosed after surgery, which did not respond to conservative management. The procedure consists of the following steps: intraoperative cystoscopy, anatomical direct repair of the fistulous tract between the bladder and vagina, and modified Martius flap. CONCLUSIONS: Martius flap is a repair technique used for complex fistula in the perineal region. It is a simple, safe, and reproducible procedure with good long-term functional and esthetic results.
BACKGROUND:Fistula repair in the perineal region represents a major challenge for surgeons. It is important for the medical community to facilitate and disclose these techniques. OBJECTIVE: The aim of this article was to show a stepwise approach for a direct repair and use of a Martius flap for a vesicovaginal fistula. METHODS: We show a single case performed in a patient who presented with a vesicovaginal fistula diagnosed after surgery, which did not respond to conservative management. The procedure consists of the following steps: intraoperative cystoscopy, anatomical direct repair of the fistulous tract between the bladder and vagina, and modified Martius flap. CONCLUSIONS: Martius flap is a repair technique used for complex fistula in the perineal region. It is a simple, safe, and reproducible procedure with good long-term functional and esthetic results.
Authors: Jon D Vogel; Eric K Johnson; Arden M Morris; Ian M Paquette; Theodore J Saclarides; Daniel L Feingold; Scott R Steele Journal: Dis Colon Rectum Date: 2016-12 Impact factor: 4.585