title: Surgical repair of a complicated urethro-vaginal fistula: case report and review of the literature.
abstract: BACKGROUND
  Urethro-vaginal fistulae (UVF) occur usually as infrequent complications of a variety of gynecological surgical procedures. The aim of this study was to present an interesting case of a complicated UVF diagnosed after gynaecological surgery.
  
  
  METHODS
  A 61-year-old gravida-2, para-2, post-menopausal woman was referred with a complaint of urine loss through the vagina. She had undergone anterior and posterior vaginal wall repair due to cystocele and stress urinary incontinence (SUI). Transvaginal repair was performed 20 weeks after primary surgery. However, a second transvaginal reconstructive surgery using Martius-flap originating from the bulbocavernosus muscle was necessary due to persistent urine leakage in the vagina. Thirty-two months after successful urethro-vaginal treatment, the patient self-referred for persistent SUI. Burch colposuspension was performed and at 16 months follow-up the patient remains continent.
  
  
  CONCLUSIONS
  Surgical repair of complicated UVF seems to be more successful with Martius flap interposition than with no interposition.
authors.affiliation: Second Department of Obstetrics and Gynecology, University of Athens, Medical School, Aretaieion Hospital, Athens, Greece. xarisgrigoriadis@yahoo.gr
authors.forename: C
authors.initials: C
authors.lastname: Grigoriadis
authors.forename: P
authors.initials: P
authors.lastname: Bakas
authors.forename: A
authors.initials: A
authors.lastname: Liapis
mesh_terms: D005260:Female; D006801:Humans; D008875:Middle Aged; D011183:Postoperative Complications / Q000601:surgery*; D014548:Urinary Fistula / Q000601:surgery*; D014550:Urinary Incontinence, Stress / Q000601:surgery*; D014624:Vaginal Fistula / Q000601:surgery*