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Vesicovaginal Fistula Repair by Modified Martius Flap: A Step-by-Step Surgical Technique Video
Tiermes Marina1, Víctor Lago2, Pablo Padilla2
1Department of Gynecologic Oncology, University Hospital La Fe, Valencia, Spain. tiermesm@gmail.com.
Background:
Fistula repair in the perineal region represents a major challenge for surgeons. It is important for the medical community to facilitate and disclose these techniques.
Objective:
The aim of this article was to show a stepwise approach for a direct repair and use of a Martius flap for a vesicovaginal fistula.
Methods:
We show a single case performed in a patient who presented with a vesicovaginal fistula diagnosed after surgery, which did not respond to conservative management. The procedure consists of the following steps: intraoperative cystoscopy, anatomical direct repair of the fistulous tract between the bladder and vagina, and modified Martius flap.
Conclusions:
Martius flap is a repair technique used for complex fistula in the perineal region. It is a simple, safe, and reproducible procedure with good long-term functional and esthetic results.
