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Updated: Aug 16, 2026
Vessel-sparing Excision and Primary Anastomosis
Published on: January 7, 2019
Martius repair in urethrovaginal defects
Didem Baskin1, Soner Tatlidede, Semra Hacikerim Karşidağ
1Department of Pediatric Surgery, Sişli Etfal Education and Research Hospital, 34394 Istanbul, Turkey. didibas@tnn.net
Aim:
To repair a urethrovaginal defect in childhood is a challenge for a pediatric surgeon. Martius fat-pad flap repair is being used in women successfully. Here, we report 2 girls who had Martius repair for their urethrovaginal defects.
Method:
Topical estriol and asiaticoside perineally were administered for preoperative 3 weeks to reinforce the tissues. Martius repair was done using 1-sided labial fat-pad flap. Urethral and bladder catheters were inserted. Urethral catheter was removed on postoperative day 14 and bladder catheter on day 21 after controlling residual urine.
Patients:
Patient 1, a 6-year-old girl, had lipomeningocele repair at the age of 18 months and had an iatrogenic urethrovaginal fistula that is caused by catheter insertion. She developed urinary incontinence, and 3 primary repair attempts were unsuccessful. Patient 2 is a 5-year-old girl who had pouch colon with persistent cloacal malformation and had posterior anorectovaginourethroplasty. The urethrovaginal septum did not heal, and she was incontinent. One attempt of primary repair was unsuccessful. The urethrovaginal wall was completely open at the time of Martius repair in both patients.
Results:
Urethral wall was completely healed after Martius repair in both patients.
Conclusion:
Martius fat-pad flap repair can be used to repair urethrovaginal fistulas in girls. It has both functionally and cosmetically good results, and neourethra is easily catheterizable.
