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Case Reports
. 2009 Apr;14(2):76-7.
doi: 10.4103/0971-9261.55159.

Urethral substitution with ileum in traumatic bladder neck-vagina fistula

Lavanya Kannaiyan  1 , Sudipta Sen
Affiliations
Case Reports

Urethral substitution with ileum in traumatic bladder neck-vagina fistula

Lavanya Kannaiyan et al. J Indian Assoc Pediatr Surg. 2009 Apr.

Abstract

A five-year-old girl presented with post traumatic urinary incontinence secondary to rupture of the bladder neck into the vagina. Operative repair included a midline exposure with resection of the symphysis pubis, separation of the bladder neck from the vagina, repair of the torn bladder neck and urethral substitution with ileum. Normal continence and voiding was achieved.

Keywords: Ileum; rectus muscle flap; urethral reconstruction; urethrovaginal fistula.

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Conflict of interest statement

Conflict of Interest: None declared.

Figures

Figure 1
Figure 1
Schematic Diagram of the operative procedure. (a) Lower midline incision including the mons pubis and the anterior part of the vulval outlet. Anterior pubic symphysis excised. (b) Pathological anatomy exposed showing posterior rupture of bladder neck into the anterior vagina. Distal urethra destroyed by injury. (c) Surgical separation of bladder neck from the vagina. (d) Bladder neck repaired posteriorly and connected to Monti tube neourethra. Left lower rectus muscle flap placed between reconstruction and vagina to prevent refistulization. Appendicular Mitrofanoff also created.
Figure 2
Figure 2
Post operative micturating cystourethrogram. Bladder was filled via the Mitrofanoff port and the patient voided via the reconstructed bladder neck and ileal neourethra.
See this image and copyright information in PMC

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