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Updated: Oct 14, 2025
Vessel-sparing Excision and Primary Anastomosis
Published on: January 7, 2019
Urethrovaginal fistula 11 years after a bone anchor sling using woven polyester and treatment with a Martius flap
Kumiko Kato1, Akitaka Suzuki2,3, Yuji Hayashi4
1Departments of Female Urology Japanese Red Cross Aichi Medical Center Nagoya Daiichi Hospital Nagoya Japan.
Introduction:
We encountered a urethrovaginal fistula diagnosed 11 years after a bone anchor sling.
Case Presentation:
A 58-year-old woman underwent a bone anchor sling to treat stress urinary incontinence. At age 69, mid-urethral sling was planned because of a recurrent stress urinary incontinence diagnosis, but a urethrovaginal fistula was found immediately before the procedure. After removing woven polyester, the previous sling material, simple fistula closure was carried out but failed. Usage of a vaginal speculum and powerful medical lamps during a stress test revealed leakage from both the urethrovaginal fistula and the external urethral meatus. She underwent another fistula closure using a Martius flap. Subsequently, a 1-h pad test improved from 195 to 5.1 g/h. The remaining mild stress urinary incontinence did not necessitate further treatment.
Conclusion:
Anti-incontinence procedures using synthetic materials can cause urethrovaginal fistula. Attention must be paid to the possibility of urethrovaginal fistula when patients complain of worsened incontinence postoperatively.
