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Urethro-Vaginal Fistula Repair

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Abstract

Urethro-vaginal fistula (UVF) is an uncommon urological condition. Most of the causes are iatrogenic from vaginal surgeries in the developed world [1]. Contributing etiology includes urethral trauma, synthetic mid-urethral slings, urethral diverticulum and radiation. The treatment is often difficult, since the operative field is restricted usually from inflammation and/or scarring and reconstructing the urethra requires not only anatomical restoration but also achieving functional urinary continence.

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References

  1. Leach GE. Urethrovaginal fistula repair with Martius labial fat pad graft. Urol Clin North Am. 1991;18:409–13.

    CAS  PubMed  Google Scholar 

  2. Keettel WC, Sehring FG, deProsse CA, Scott JR. Surgical management of urethrovaginal and vesicovaginal fistulas. Am J Obstet Gynecol. 1978;131:425–31.

    Article  CAS  PubMed  Google Scholar 

  3. Blaivas JG. Treatment of female incontinence secondary to urethral damage or loss. Urol Clin North Am. 1991;18:355–63.

    CAS  PubMed  Google Scholar 

  4. Goodwin WE, Scardino PT. Vesicovaginal and urethrovaginal fistulas: a summary of 25 years of experience. Trans Am Assoc GU Surg. 1979;71:123–9.

    CAS  Google Scholar 

  5. Lee RA. Current status of genitourinary fistula. Obstet Gynecol. 1988;72:313–9.

    CAS  PubMed  Google Scholar 

  6. Hilton P. Urogenital fistula in the UK: a personal case series managed over 25 years. BJU Int. 2012;110(1):102–10.

    Article  PubMed  Google Scholar 

  7. Ockrim JL, Greenwell TJ, Foley CL, Wood DN, Shah PJ. A tertiary experience of vesico-vaginal and urethro-vaginal fistula repair: factors predicting success. BJU Int. 2009;103(8):1122–6.

    Article  PubMed  Google Scholar 

  8. Pushkar DY, Dyakov VV, Kosko JW, Kasyan GR. Management of urethrovaginal fistulas. Eur Urol. 2006;50(5):1000–5.

    Article  PubMed  Google Scholar 

  9. Blaivas JG, Mekel G. Management of urinary fistulas due to midurethral sling surgery. J Urol. 2014;192(4):1137–42.

    Article  PubMed  Google Scholar 

  10. Lee D, Zimmern PE. Long-term functional outcomes following non-radiated urethrovaginal fistula repair. World J Urol. 2016;34(2):291–6.

    Article  PubMed  Google Scholar 

  11. Vassallo BJ, Kleeman SD, Segal J, Karram MM. Urethral erosion of a tension-free vaginal tape. Obstet Gynecol. 2003;101:1055–8.

    PubMed  Google Scholar 

  12. Reisenauer C, Wallwiener D, Stenzl A, Solomayer FE, Sievert KD. Urethrovaginal fistula—a rare complication after the placement of a suburethral sling (ivs). Int Urogynecol J Pelvic Floor Dysfunct. 2007;18:343–6.

    Article  PubMed  Google Scholar 

  13. Clemens JQ, DeLancey JO, Faerber GJ, Westney OL, McGuire EJ. Urinary tract erosions after synthetic pubovaginal slings: diagnosis and management strategy. Urology. 2000;56:589–94.

    Article  CAS  PubMed  Google Scholar 

  14. Estevez JP, Cosson M, Boukerrou M. An uncommon case of urethrovaginal fistula resulting from tension-free vaginal tape. Int Urogynecol J. 2010;21:889–91.

    Article  PubMed  Google Scholar 

  15. Siegel AL. Urethral necrosis and proximal urethro-vaginal fistula resulting from tension-free vaginal tape. Int Urogynecol J. 2006;17:661–4.

    Article  Google Scholar 

  16. Chung C, Kingman T, Tsai L, Bird E. Serious complications from a single-incision midurethral sling placement. Obstet Gynecol. 2012;119(2 Pt 2):464–6.

    Article  PubMed  Google Scholar 

  17. Deffieux X, Bonnet K, Chevalier N, Gervaise A, Frydman R, Fernandez H. Urinary complications in sub-urethral sling procedures. J Gynecol Obstet Biol Reprod (Paris). 2005;34:745–56.

    Article  CAS  Google Scholar 

  18. Popat S, Zimmern PE. Long-term outcomes after the excision of horseshoe urethral diverticulum. Int Urogynecol J. 2016;27(3):439–44.

    Article  PubMed  Google Scholar 

  19. Blander D, Zimmern PE. Chapter 22. Zimmern S, editor. Urethral diverticulum and urethrovaginal fistula female pelvic reconstructive surgery. Springer; 2002. p. 299–311.

    Google Scholar 

  20. Lee D, Dillon BE, Zimmern PE. Long-term morbidity of Martius labial fat pad graft in vaginal reconstruction surgery. Urology. 2013;82(6):1261–6.

    Article  PubMed  Google Scholar 

  21. Lee D, Dillon BE, Zimmern PE. Martius labial fat pad procedure: technique and long-term outcomes. Int Urogynecol J. 2015;26(9):1395–6.

    Article  PubMed  Google Scholar 

  22. Lee D, Alhalabi F, Zimmern P. Long term results after fascia lata pubovaginal sling for complex incontinence secondary to intrinsic sphincteric deficiency. ICS. 2015:Abstract 144.

    Google Scholar 

  23. Lowman J, Moore RD, Miklos JR. Tension-free vaginal tape sling with a porcine interposition graft in an irradiated patient with a past history of a urethrovaginal fistula and urethral mesh erosion: a case report. J Reprod Med. 2007;52:560–2.

    PubMed  Google Scholar 

  24. Dillon B, Gurbuz C, Zimmern P. Long term results after complication of “prophylactic” suburethral tape placement. Can J Urol. 2012;19:6424–30.

    PubMed  Google Scholar 

  25. Milose JC, Sharp KM, He C, Stoffel J, Clemens JQ, Cameron AP. Success of autologous pubovaginal sling after failed synthetic mid urethral sling. J Urol. 2015;193(3):916–20.

    Article  PubMed  Google Scholar 

  26. Stav K, Dwyer PL, Rosamilia A, Schierlitz L, Lim YN, et al. Repeat synthetic mid urethral sling procedure for women with recurrent stress urinary incontinence. J Urol. 2010;183(1):241–6.

    Article  PubMed  Google Scholar 

  27. Leng WW, Davies BJ, Tarin T, Sweeney DD, Chancellor MB. Delayed treatment of bladder outlet obstruction after sling surgery: association with irreversible bladder dysfunction. J Urol. 2004;172(4 Pt 1):1379–81.

    Article  PubMed  Google Scholar 

  28. Starkman JS, Duffy 3rd JW, Wolter CE, Kaufman MR, Scarpero HM, Dmochowski RR. The evolution of obstruction induced overactive bladder symptoms following urethrolysis for female bladder outlet obstruction. J Urol. 2008;179(3):1018–23.

    Article  PubMed  Google Scholar 

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Correspondence to Dominic Lee MD .

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Lee, D. (2017). Urethro-Vaginal Fistula Repair. In: Zimmern, P., De, E. (eds) Native Tissue Repair for Incontinence and Prolapse. Springer, Cham. https://doi.org/10.1007/978-3-319-45268-5_16

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  • DOI: https://doi.org/10.1007/978-3-319-45268-5_16

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-45266-1

  • Online ISBN: 978-3-319-45268-5

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