Full-thickness Martius grafts to preserve vaginal depth as an adjunct in the repair of large obstetric fistulas.
We performed a modified bulbocavernosus full-thickness pedicle graft procedure on four patients with large obstetric fistulas in Ghana, West Africa. The bulbocavernosus fat pad was harvested in the usual manner, and the full-thickness skin patch was taken from the medial thigh. All grafts showed 100% take by the tenth postoperative day. Adequate vaginal depth and caliber were obtained in all patients. Sexual function resumed in all patients except one, who suffered a recurrent vesicovaginal fistula. This method of vaginoplasty may be useful in patients who have massive vaginal-wall destruction of either gynecologic or obstetric origin.
Margolis
T
T
Emory University, Atlanta, Georgia.
Elkins
T E
TE
Seffah
J
J
Oparo-Addo
H S
HS
Fort
D
D
D000328:Adult; D005260:Female; D006085:Graft Survival; D006801:Humans; D010865:Pilot Projects; D012006:Rectovaginal Fistula / Q000150:complications / Q000601:surgery*; D012086:Reoperation / Q000379:methods; D012725:Sexual Behavior; D013524:Surgical Flaps / Q000379:methods*; D017211:Treatment Failure; D014522:Urethral Diseases / Q000150:complications / Q000601:surgery*; D014548:Urinary Fistula / Q000150:complications / Q000601:surgery*; D014624:Vaginal Fistula / Q000150:complications / Q000601:surgery*; D014719:Vesicovaginal Fistula / Q000150:complications / Q000601:surgery*; D014844:Vulva / Q000098:blood supply; D014945:Wound Healing