title: Martius' labial fat pad interposition and its modification in complex lower urinary fistulae.
abstract: OBJECTIVE
  To assess the results of Martius' labial fat pad interposition and its modification using skin island in the repair of giant and recurrent vesicovaginal and urethrovaginal fistulae.
  
  
  METHODS
  Fifteen patients of urethrovaginal and vesicovaginal fistulae underwent Martius' labial fat pad interposition and its skin island modification during 1996 to 1999. Ten of these were recurrent (66%) and five were giant fistulae (34%) i.e. more than five cms.
  
  
  RESULTS
  Results were very gratifying with a successful repair in 14 patients (93%). Two patients had transient, low-grade stress incontinence, which did not need any additional procedure. In one patient, there was failure of repair, which was later successfully repaired using fat pad from opposite labia.
  
  
  CONCLUSIONS
  Martius' fat pad interposition provides vascularity and surface for epithelialisation and also prevents overlapping of vesical/urethral and vaginal suture lines. Martius' repair has good results with low morbidity in the treatment of giant and recurrent urethrovaginal and vesicovaginal fistulae.
authors.affiliation: Department of Urology, Seth G. S. Medical College, Parel, Mumbai, India.
authors.forename: S V
authors.initials: SV
authors.lastname: Punekar
authors.forename: D N
authors.initials: DN
authors.lastname: Buch
authors.forename: A B
authors.initials: AB
authors.lastname: Soni
authors.forename: G
authors.initials: G
authors.lastname: Swami
authors.forename: S R
authors.initials: SR
authors.lastname: Rao
authors.forename: J S
authors.initials: JS
authors.lastname: Kinne
authors.forename: S S
authors.initials: SS
authors.lastname: Karhadkar
mesh_terms: D005260:Female; D006801:Humans; D012008:Recurrence; D013524:Surgical Flaps; D014522:Urethral Diseases / Q000601:surgery*; D014548:Urinary Fistula / Q000601:surgery*; D014719:Vesicovaginal Fistula / Q000601:surgery*