Skin flap vaginal augmentation helps prevent and cure post obstetric fistula repair urine leakage: a critical anatomical analysis

Our aim was to describe a new surgical method for prophylaxis/cure of post -obstetric fistula repair leakage based on restoring vaginal elasticity with Singapore skin flap. The rationale for this operation was based on the Integral Theory: scarring removes elasticity required for independent function of oppositely-acting urethral closure forces so they become 'tethered, forcibly opening the urethra when give the signal to close. Skin graft restores elasticity and closure. Used prophylactically with Goh type 4 fistula (n=45) 46% were dry against expected 19%. In patients with successful fistula closure, still severe leakage (n=24), 71% were dry against expected 26%. This article is protected by copyright. All rights reserved.

BJOG : an international journal of obstetrics and gynaecology. 2017 Oct 11 [Epub ahead of print]

Andrew Browning, Gordon Williams, Peter Petros

Director Maternity Arusha Tanzania., Ministry of Health Addis Ababa Ethiopia., St Vincent's Hospital Clinical School, University of NSW, Sydney, Professorial Unit, Department of Surgery.