Management of neobladder-vaginal fistula and stress incontinence following radical cystectomy in women

a review.

Hari S G R Tunuguntla, Murugesan Manoharan, Angelo E. Gousse

Research output: Contribution to journalArticle

21 Citations (Scopus)

Abstract

Contemporary literature regarding the management of neobladder-vaginal fistula and stress urinary incontinence following radical cystectomy and neobladder reconstruction in women is reviewed in this article. Neobladder-vaginal fistula is uncommon but mandates meticulous repair. Compared to the native bladder, the wall of the neobladder is much thinner that may render it vulnerable to fistulization. Preservation of the anterior vaginal wall during radical cystectomy decreases the likelihood of pouch-vaginal fistula. Omental flap interposition between the vaginal stump and neobladder at cystectomy may not always prevent fistulization if anterior vaginal wall is violated or overlapping suture lines are not avoided. Surgery for intractable stress incontinence following neobladder reconstruction is fraught with severe complications and requires judicious use of allograft pubovaginal slingplasty possibly with bone anchors. Martius flap interposition appears to play a crucial role in improving the outcome following transvaginal repair of the neobladder-vaginal fistula in multiple non-overlapping layers.

Original languageEnglish
Pages (from-to)231-235
Number of pages5
JournalWorld journal of urology.
Volume23
Issue number4
StatePublished - Sep 1 2005

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Vaginal Fistula
Cystectomy
Suture Anchors
Literature
Stress Urinary Incontinence
Sutures
Allografts
Urinary Bladder

ASJC Scopus subject areas

  • Urology

Cite this

Management of neobladder-vaginal fistula and stress incontinence following radical cystectomy in women : a review. / Tunuguntla, Hari S G R; Manoharan, Murugesan; Gousse, Angelo E.

In: World journal of urology., Vol. 23, No. 4, 01.09.2005, p. 231-235.

Research output: Contribution to journalArticle

Tunuguntla, Hari S G R ; Manoharan, Murugesan ; Gousse, Angelo E. / Management of neobladder-vaginal fistula and stress incontinence following radical cystectomy in women : a review. In: World journal of urology. 2005 ; Vol. 23, No. 4. pp. 231-235.
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