title: Concomitant repair of stress urinary incontinence with proximal urethrovaginal fistula: Our experience.
abstract: BACKGROUND
  Proximal urethrovaginal fistula (UVF) located close to the bladder neck may cause extensive sphincter damage and is usually associated with continuous incontinence, which may mask the associated stress urinary incontinence (SUI). Simultaneous correction of SUI avoids a second surgery for SUI, which needs dissection in ischemic fields and carries a high risk of failure. The aim of this study is to describe our technique of concomitant repair of SUI with proximal UVF and our results.
  
  
  METHODS
  Between July 2010 and August 2014, 14 patients underwent UVF repair in Jackknife position by the interposition of a Martius flap and simultaneous correction of SUI by modified McGuire pubovaginal autologous fascial sling. The procedure was carried out a minimum of 3 months of presentation and after detailed preoperative evaluation.
  
  
  RESULTS
  After a mean follow-up of 28 months, all 14 patients were continent. None of the patients developed recurrence of the UVF. Two patients presented with retention immediately after catheter removal and clean intermittent catheterization training was given to both of them. Two patients became pregnant during the follow-up period and were advised cesarean section near term.
  
  
  CONCLUSIONS
  Repair of proximal UVF and correction of SUI can be performed in the same session to avoid the operation in an ischemic field.
authors.affiliation: Department of Urology, Andhra Medical College, King George Hospital, Visakhapatnam, Andhra Pradesh, India.
authors.forename: Subbarao
authors.initials: S
authors.lastname: Chodisetti
authors.affiliation: Department of Urology, Andhra Medical College, King George Hospital, Visakhapatnam, Andhra Pradesh, India.
authors.forename: Yogesh
authors.initials: Y
authors.lastname: Boddepalli
authors.affiliation: Department of Urology, Andhra Medical College, King George Hospital, Visakhapatnam, Andhra Pradesh, India.
authors.forename: Malakonda Reddy
authors.initials: MR
authors.lastname: Kota
keywords: Autologous fascial sling; McGuire pubovaginal sling; stress urinary incontinence; urethrovaginal fistula