Successful closure of a bladder neck fistula complicated by urethral and vaginal stenosis, using oxidized cellulose (Surgicel) for reinforcement.
We describe a case of a bladder neck fistula in a 25-year-old lady presenting with true urinary incontinence, vaginal constriction and induration, with vaginal length reduced to only 1.5 cm. There was an 8-mm fistula involving upper urethra and bladder neck, with fibrosis all around. Using Schuchardt incision, the fistula was reached and mobilization tried. As there was less available tissue, a 3 x 2-cm layer of oxidized cellulose was stitched between the bladder and the vaginal mucosa for reinforcement and to achieve a watertight closure of fistula.
Mittal
Suneeta
S
Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, New Delhi, India.
Sharma
J B
JB
Gupta
Nupur
N
D000328:Adult; D002483:Cellulose, Oxidized / Q000627:therapeutic use; D003251:Constriction, Pathologic; D005260:Female; D006490:Hemostatics / Q000627:therapeutic use; D006801:Humans; D014525:Urethral Stricture / Q000601:surgery*; D014549:Urinary Incontinence / Q000209:etiology / Q000601:surgery; D014552:Urinary Tract Infections / Q000188:drug therapy; D014621:Vagina / Q000473:pathology* / Q000601:surgery; D014719:Vesicovaginal Fistula / Q000601:surgery*
D002483:Cellulose, Oxidized; D006490:Hemostatics