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

D. H. Evans, S. Madjar, V. A. Politano, D. E. Bejany, Charles M Lynne, A. E. Gousse

Research output: Contribution to journalArticle

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Abstract

Objectives. To evaluate the use of interposition flaps in repairing vesicovaginal fistulas (VVFs) of benign and malignant etiologies. Interposition flaps are not routinely used in the repair of VVFs when the surrounding tissues appear healthy and well-vascularized, such as in a benign etiology.Methods. We retrospectively reviewed the charts of 37 women (mean age 49.1 years) at our institution who underwent transabdominal repair of their VVF by urologic surgeons between August 1978 and June 1999. The preoperative and postoperative medical records were reviewed.Results. Of the 37 VVFs repaired transabdominally, 29 had a benign etiology (25 related to gynecologic procedures) and 8 a malignant etiology (all related to gynecologic neoplasia). Of the 29 benign VVFs, an interposition flap was used in 10 repairs with all 10 successful (100%). The remaining 19 benign VVF repairs were performed without using a flap, with 12 successful (63%). Of the 8 malignant fistulas, an interposition flap was used in 2 repairs with both successful (100%). The remaining 6 malignant VVF repairs were performed without a flap, with 4 successful (67%).Conclusions. The results of our study indicate a higher success rate for transabdominal VVF repairs performed with an interposition flap (100% success rate at our institution). This observation holds true regardless of the appearance of healthy surrounding tissue or, more importantly, a benign or malignant etiology. We recommend interposition flaps in transabdominal repairs of VVFs, even in the cases of benign fistulas with well-preserved surrounding tissue.

Original languageEnglish
Pages (from-to)670-674
Number of pages5
JournalUrology
Volume57
Issue number4
StatePublished - Apr 1 2001

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Vesicovaginal Fistula
Fistula
Medical Records

ASJC Scopus subject areas

  • Urology

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Evans, D. H., Madjar, S., Politano, V. A., Bejany, D. E., Lynne, C. M., & Gousse, A. E. (2001). Interposition flaps in transabdominal vesicovaginal fistula repairs: are they really necessary? Urology, 57(4), 670-674.

Interposition flaps in transabdominal vesicovaginal fistula repairs : are they really necessary? / Evans, D. H.; Madjar, S.; Politano, V. A.; Bejany, D. E.; Lynne, Charles M; Gousse, A. E.

In: Urology, Vol. 57, No. 4, 01.04.2001, p. 670-674.

Research output: Contribution to journalArticle

Evans, DH, Madjar, S, Politano, VA, Bejany, DE, Lynne, CM & Gousse, AE 2001, 'Interposition flaps in transabdominal vesicovaginal fistula repairs: are they really necessary?', Urology, vol. 57, no. 4, pp. 670-674.
Evans DH, Madjar S, Politano VA, Bejany DE, Lynne CM, Gousse AE. Interposition flaps in transabdominal vesicovaginal fistula repairs: are they really necessary? Urology. 2001 Apr 1;57(4):670-674.
Evans, D. H. ; Madjar, S. ; Politano, V. A. ; Bejany, D. E. ; Lynne, Charles M ; Gousse, A. E. / Interposition flaps in transabdominal vesicovaginal fistula repairs : are they really necessary?. In: Urology. 2001 ; Vol. 57, No. 4. pp. 670-674.
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abstract = "Objectives. To evaluate the use of interposition flaps in repairing vesicovaginal fistulas (VVFs) of benign and malignant etiologies. Interposition flaps are not routinely used in the repair of VVFs when the surrounding tissues appear healthy and well-vascularized, such as in a benign etiology.Methods. We retrospectively reviewed the charts of 37 women (mean age 49.1 years) at our institution who underwent transabdominal repair of their VVF by urologic surgeons between August 1978 and June 1999. The preoperative and postoperative medical records were reviewed.Results. Of the 37 VVFs repaired transabdominally, 29 had a benign etiology (25 related to gynecologic procedures) and 8 a malignant etiology (all related to gynecologic neoplasia). Of the 29 benign VVFs, an interposition flap was used in 10 repairs with all 10 successful (100{\%}). The remaining 19 benign VVF repairs were performed without using a flap, with 12 successful (63{\%}). Of the 8 malignant fistulas, an interposition flap was used in 2 repairs with both successful (100{\%}). The remaining 6 malignant VVF repairs were performed without a flap, with 4 successful (67{\%}).Conclusions. The results of our study indicate a higher success rate for transabdominal VVF repairs performed with an interposition flap (100{\%} success rate at our institution). This observation holds true regardless of the appearance of healthy surrounding tissue or, more importantly, a benign or malignant etiology. We recommend interposition flaps in transabdominal repairs of VVFs, even in the cases of benign fistulas with well-preserved surrounding tissue.",
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