Neobladder-Vaginal Fistula: Surgical Management Techniques

Kaufman, Melissa R.

doi:10.1007/s11934-019-0934-0

Cited by 3 publications

(4 citation statements)

References 28 publications

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“…Furthermore, it is difficult to assess the extent of incontinence in patients with NVF, and repair of NVF could aggravate the incontinence itself. 14 Table 3 compares our results with those of recently published studies of NVF repair. [6][7][8]15 These case series included 6-14 patients with NVF, with an incidence of NVF ranging from 2.7% to 6.0%.…”

Section: Discussionmentioning

confidence: 68%

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<p>Surgical Outcomes of Transvaginal Neobladder-Vaginal Fistula Repair After Radical Cystectomy with Ileal Orthotopic Neobladder: A Case–Control Study</p>

Lee

Song

2020

CMAR

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Purpose: To present surgical methods and outcomes in women with bladder cancer (BCa) requiring correction of neobladder-vaginal fistula (NVF) after radical cystectomy (RC) with ileal orthotopic neobladder (IONB). Materials and Methods: The medical records of 163 women who underwent RC with IONB for BCa between January 2010 and December 2018 were retrospectively reviewed. The presence of NVF was confirmed by cystoscopy and/or voiding cystography. NVF repair was performed using a transvaginal approach, which included circumferential incision of the fistula tract, creation of a plane between the neobladder serosa and the vaginal epithelium, and multi-layered transvaginal closure. Results: During a median follow-up of 47.9 months, NVF was identified in 12 (8.8%) of the 163 included women. Eight (66.7%) fistulas were located in the proximal anterior vaginal wall and four (33.3%) in the vaginal apex. Median time from RC to NVF repair was 3.4 months (range, 2.1-5.6 months), median NVF size was 6.0 mm (range, 4.0-22.0 mm), and median duration of urethral Foley catheter indwelling was 24.0 days (range, 15.0-43.0 days). Initial repair of NVF was successful in ten (83.3%) patients. Two (16.7%) patients who relapsed retained IONB through the subsequent operation. Two (16.7%) patients developed severe urinary incontinence after NVF repair, requiring anti-incontinence surgery with a synthetic transobturator mid-urethral sling. Conclusion: The transvaginal approach for NVF repair is feasible, yielding successful surgical outcomes. However, women should be counseled about the risks of relapse and urinary incontinence.

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Section: Discussionmentioning

confidence: 68%

“…Tissue interposition has been reported to be effective for NVF repair. 14 An omental flap is preferred, as it is robust and does not require additional incision. 8 If an omental flap is unavailable, a Martius labial fat flap can be used because it offers extra-vascularization and a better epithelization surface.…”

Section: Discussionmentioning

confidence: 99%

<p>Surgical Outcomes of Transvaginal Neobladder-Vaginal Fistula Repair After Radical Cystectomy with Ileal Orthotopic Neobladder: A Case–Control Study</p>

Lee

Song

2020

CMAR

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“…Author details 1 Department of Urology, Affiliated Sanming First Hospital, Fujian Medical University, Sanming 365000, Fujian, China. 2 Department of Urology, Sun Yat-Sen Memorial Hospital, Sun Yat-sen, Guangzhou 510655, Guangdong, China.…”

Section: Abbreviationsmentioning

confidence: 99%

“…The aetiology of INF is unclear. The early cause of INF may be local damage to the bowel, and the overlap of the ileal end-to-end anastomosis site with the neobladder suture of the ileum may be one of the causes of INF [2,3]. In addition, local pelvic radiotherapy, long-term indwelling urinary catheters and local recurrence of tumours are possible causes of delayed INF [4].…”

Section: Introductionmentioning

confidence: 99%

Delayed ileal neobladder fistula caused by bladder stones: a case report

Liao

et al. 2022

BMC Urol

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Background Ileal neobladder fistula is a rare complication after radical cystectomy, with an incidence of approximately 0.7%. At present, there are scattered reports of vesicoileal fistula, but there are no reports of ileal neobladder fistula (INF) caused by bladder stones. In this paper, a case of ileal neobladder fistula caused by chronic stimulation of bladder stones was successfully diagnosed and treated. Case presentation A 68-year-old man who had undergone radical cystectomy and an orthotopic ileal neobladder procedure 10 years prior presented with refractory diarrhoea and oliguria and was diagnosed with ileal neobladder fistula caused by chronic stimulation of bladder stones. We performed fistulectomy, cystotomy, partial ileectomy, and end-to-end ileal anastomosis, and the patient recovered and was discharged after the operation. Conclusion Urinary calculi are delayed complications of orthotopic neobladder construction after total cystectomy. Bladder stones are a rare complication of ileal neovesical fistula, which can cause neovesical cutaneous fistula. It is difficult to diagnose through routine examination and easily misdiagnosed as acute gastroenteritis. Surgery is an effective treatment for INF and can achieve a good prognosis.

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Incontinence After Complex Urinary Reconstruction: Orthotopic Neobladder and Gender-Affirming Surgery

Amanda

et al. 2022

Female Urinary Incontinence

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Neobladder-Vaginal Fistula: Surgical Management Techniques

Cited by 3 publications

References 28 publications

<p>Surgical Outcomes of Transvaginal Neobladder-Vaginal Fistula Repair After Radical Cystectomy with Ileal Orthotopic Neobladder: A Case–Control Study</p>

<p>Surgical Outcomes of Transvaginal Neobladder-Vaginal Fistula Repair After Radical Cystectomy with Ileal Orthotopic Neobladder: A Case–Control Study</p>

Delayed ileal neobladder fistula caused by bladder stones: a case report

Incontinence After Complex Urinary Reconstruction: Orthotopic Neobladder and Gender-Affirming Surgery

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