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[A case of vesicovaginal fistula repair with rectus abdominus myofascial interposition flap after radical hysterectomy and radiation therapy].

Abstract
Vesicovaginal fistulas (VVFs) caused after radiation are difficult to repair and require interposition of non-irradiated, well-vascularized tissue between urinary bladder and vagina. A 48-year-old female suffered cervical cancer and underwent radical hysterectomy followed by radiation therapy which caused VVF. The initial surgical repair performed 3 months after development of VVF, was unsuccessful because of the absence of peritoneum or omentum to interpose between urinary bladder and vagina probably due to history of cesarean section and radical hysterectomy. The second surgical repair was performed 15 months after the first surgery utilizing a rectus abdominus myofascial (RAM) interposition flap. Fifteen months after the second operation, she remains free from incontinence. This case suggests that RAM is useful even for postradiation VVF.
AuthorsYuki Endo, Shigeki Iigaya, Taiji Nishimura, Naohiro Ishii, Yoshihisa Kitaoka, Toshifumi Kawashima, Chiharu Ohara, Tsutomu Hamasaki, Yukihiro Kondo
JournalHinyokika kiyo. Acta urologica Japonica (Hinyokika Kiyo) Vol. 60 Issue 10 Pg. 497-9 (Oct 2014) ISSN: 0018-1994 [Print] Japan
PMID25391781 (Publication Type: Case Reports, English Abstract, Journal Article)
Topics
  • Female
  • Humans
  • Hysterectomy (adverse effects)
  • Middle Aged
  • Radiotherapy (adverse effects)
  • Surgical Flaps
  • Uterine Cervical Neoplasms (radiotherapy, surgery)
  • Vesicovaginal Fistula (etiology, surgery)

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