[A case of vesicovaginal fistula repair with rectus abdominus myofascial interposition flap after radical hysterectomy and radiation therapy].
Vesicovaginal fistulas (VVFs) caused after radiation are difficult to repair and require interposition of non-irradiated, well-vascularized tissue between urinary bladder and vagina. A 48-year-old female suffered cervical cancer and underwent radical hysterectomy followed by radiation therapy which caused VVF. The initial surgical repair performed 3 months after development of VVF, was unsuccessful because of the absence of peritoneum or omentum to interpose between urinary bladder and vagina probably due to history of cesarean section and radical hysterectomy. The second surgical repair was performed 15 months after the first surgery utilizing a rectus abdominus myofascial (RAM) interposition flap. Fifteen months after the second operation, she remains free from incontinence. This case suggests that RAM is useful even for postradiation VVF.
The Department of Urology, Nasu Red Cross Hospital.
Yuki
Y
Endo
The Department of Urology, Nasu Red Cross Hospital.
Shigeki
S
Iigaya
The Department of Urology, Nasu Red Cross Hospital.
Taiji
T
Nishimura
The Department of Plastic Surgery, Nasu Red Cross Hospital.
Naohiro
N
Ishii
The Department of Obstetrics and Gynecology, Nasu Red Cross Hospital.
Yoshihisa
Y
Kitaoka
The Department of Surgery, Nasu Red Cross Hospital.
Toshifumi
T
Kawashima
The Department of Respiratory Medicine, Nasu Red Cross Hospital.
Chiharu
C
Ohara
The Department of Urology, Nippon Medical School.
Tsutomu
T
Hamasaki
The Department of Urology, Nippon Medical School.
Yukihiro
Y
Kondo
D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000009:adverse effects; D008875:Middle Aged; D011878:Radiotherapy / Q000009:adverse effects; D013524:Surgical Flaps; D002583:Uterine Cervical Neoplasms / Q000532:radiotherapy / Q000601:surgery*; D014719:Vesicovaginal Fistula / Q000209:etiology / Q000601:surgery*