Olatunji Okikiola Lawal
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Sadiya Nasir
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Oluwasomidoyin Olukemi Bello
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Rukiyat Adeola Abdus-salam
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Imran Oludare Morhason-Bello
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...
Abstract
Background
Successful outcome of a urinary fistula repair involves a successful closure of the fistula without residual incontinence. However, a few women have post-repair stress urinary incontinence despite closure of the fistula, which requires special surgical technique to achieve total continence.
Case presentation
Four women with post-vesicovaginal fistula repair residual incontinence were selected for sling operation using autologous rectus fascia in a low resource setting. Their ages ranged between 20 and 30 years. None had a fistulous opening on vaginal examination and dye test. Two patients had one previous attempt at repair of post-repair stress incontinence, while the others had two and three attempts, respectively, without success. The patients had none to mild vaginal adhesion. Following the procedure, they were followed up for 6 months and they remained continent of urine.
Conclusion
All patients achieved total urinary continence following autologous rectus fascia slings with minimal complications. This demonstrates the possibility of achieving a successful outcome despite lack of modern equipment for diagnosis and follow-up, a typical problem of low-income country like Nigeria.
Complex Vesicovaginal Fistula Repair with Gracilis Muscle Interposition Flap - Case Series of 5 Patients and Review of Literature
