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Comment
. 2023 Aug;34(8):1797-1802.
doi: 10.1007/s00192-023-05465-w. Epub 2023 Feb 4.

Clinical efficacy of flap transfer coverage in the treatment of vesicovaginal fistula

Xingqi Wang #  1   2 , Zhenhua Gao #  1   2 , Ling Li  1   2 , Daoming Tian  1   2 , Hang Zhou  1   2 , Jihong Shen  3   4
Affiliations
Comment

Clinical efficacy of flap transfer coverage in the treatment of vesicovaginal fistula

Xingqi Wang et al. Int Urogynecol J. 2023 Aug.

Abstract

Introduction and hypothesis: Vesicovaginal fistula (VVF) brings severe psychological, physiological, and social stress to patients, which seriously affects the quality of their sexual life. Traditional transvaginal repair surgery can cause vaginal shortening. Transferring the lateral free flap can maintain vaginal length. This study was carried out to investigate the clinical efficacy of the surgery of flap transfer coverage for treating VVF.

Methods: A retrospective analysis was performed on 37 patients diagnosed with VVF and repaired by flap transfer coverage in the Urogynecology department of the First Affiliated Hospital of Kunming Medical University from January 2018 to June 2021. All patients took a prone split leg position to repair VVF with the flap transfer covering method and a chart review was performed.

Results: Among the 37 patients, there were 34 cases of primary complete healing, and the success rate reached 91.89% without recurrence and complications. Three cases recurred with leakage of urine; cystoscopy showed that the fistula was significantly reduced, and all patients were cured after secondary repair by the same surgical method without complications.

Conclusions: Flap transfer coverage is a safe and effective surgical method for repairing VVF. The prone split leg position can better increase exposure. The fistula being away from the incision suture is the key to the success of the operation. Transferring the fistula can effectively improve the cure rate of VVF. Transferring the lateral free flap can maintain vaginal length.

Keywords: Flap transfer coverage; Retrospective analysis; Surgical technique; Transvaginal approach; Vesicovaginal fistula.

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Conflict of interest statement

The authors declare that they have no conflicts of interest.

Figures

Fig. 1
Fig. 1
The patient takes a prone split leg position
Fig. 2
Fig. 2
A A circumferential incision was made around the fistula opening at least 0.5 cm from the fistula opening. B The vaginal flap around the fistula was freed by at least 2–3 cm. C, E The fistula was sutured continuously. D, F The fistula was completely suspended and buried behind the apical/lateral free flap. G The vaginal mucosa was misaligned and closed. 1 Transferring the apical free flap, 2 transferring the lateral free flap
See this image and copyright information in PMC

Comment on

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