Department of Plastic and Reconstructive Surgery, The College of Medicine, Seoul National University, 28 Yeongun-dong, Chongno-gu, Seoul 110-744, Republic of Korea

We report our experience of supratrigonal vesicovaginal fistula (VVF) repair cases developed after gynaecologic surgery. Two patients presented with urinary incontinence after hysterectomy and adjuvant radiation therapy for cervical carcinoma. Cystoscopy findings showed vesicovaginal fistula near the bladder neck area. In a transvaginal approach, we excised the fistulous tract and transferred the genito-gluteal fold fat pad flap for interpositioning. Postoperative cystography showed no evidence of leakage and no recurrence was found after a 1 year follow-up period. This flap technique is particularly useful for a vaginal cuff area fistula in terms of ease of dissection, lower donor site morbidity and large flap dimension. Also the fat pad provides neovascularity and lymphatic drainage, fills dead space, and enhances granulation tissue formation.

Written by
Heo C, Eun S, Baek R, Minn K.

Reference
J Plast Reconstr Aesthet Surg. 2007 Nov 13 [Epub ahead of print]
doi:10.1016/j.bjps.2007.09.005

PubMed Abstract
PMID:18024252

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