title: Repair of a vesico-vaginal fistula with amniotic membrane - Step 1 of the IDEAL recommendations of surgical innovation.
abstract: BACKGROUND
  Complex vesico-vaginal fistula (VVF) has a high recurrence rate and so the repair with graft tissues seems to be favorable. Amniotic membrane (AM) plays an increasing role as a scaffold for the repair of defect tissue due to its unique biological properties with regard to promoting wound healing.
  
  
  METHODS
  An innovative surgical procedure for AM-assisted repair of a complex vesico-vaginal fistula as the Idea Stage following the IDEAL recommendations is presented. The development of amnion preparation and the involved surgical steps are described.
  
  
  RESULTS
  We are able to report a successful repair of VVF by abdominal approach with an amniotic membrane graft. Good functional results, no adverse events and no graft rejection have been detected.
  
  
  CONCLUSIONS
  Favorable results confirm the technical simplicity, safety and efficacy of this procedure. Following the IDEAL recommendations, consecutive animal experiments and a cohort study are in progress.
authors: Department of Urology, Lukas Hospital Neuss, Germany.
authors: Dimitri
authors: D
authors: Barski
authors: Department of Urology, Lukas Hospital Neuss, Germany.
authors: Holger
authors: H
authors: Gerullis
authors: Department of Urology, HELIOS Hospital, Bad Saarow, Germany.
authors: Thorsten
authors: T
authors: Ecke
authors: Institute of Experimental Surgery, University of Szeged, Hungary.
authors: Gabriella
authors: G
authors: Varga
authors: Institute of Experimental Surgery, University of Szeged, Hungary.
authors: Mihaly
authors: M
authors: Boros
authors: University of Antwerp, Laboratory of Cell Biology and Histology, Antwerp, Belgium.
authors: Isabel
authors: I
authors: Pintelon
authors: University of Antwerp, Laboratory of Cell Biology and Histology, Antwerp, Belgium.
authors: Jean-Pierre
authors: JP
authors: Timmermans
authors: University Hospital for Urology, School of Medicine and Health Sciences, Carl von Ossietzky University, Oldenburg, Germany.
authors: Alexander
authors: A
authors: Winter
authors: Department of Urology, Lukas Hospital Neuss, Germany.
authors: Jens-Willem
authors: JW
authors: Bagner
authors: Department of Urology, Lukas Hospital Neuss, Germany.
authors: Thomas
authors: T
authors: Otto
keywords: IDEAL recommendations; amniotic membrane; vesico-vaginal fistula