Surgical Approach to Urethral Diverticulum and Urethrovaginal Fistula With Mesh Erosion.
Int Urogynecol J
; 35(6): 1327-1329, 2024 Jun.
Article
em En
| MEDLINE
| ID: mdl-38733381
ABSTRACT
INTRODUCTION AND HYPOTHESIS:
This video illustrates a rare surgical case involving a urethral diverticulum, urethrovaginal fistula, and mesh erosion.METHODS:
We present a 58-year-old patient attending a tertiary care center with a suspected urethrovaginal fistula. Her concerns included stress urinary incontinence (SUI), recurrent urinary tract infection, and vaginal pain. The surgical history was notable for the placement of two different mesh slings during the same procedure to treat SUI. Preoperative evaluation and findings are illustrated in detail. The video uses a high-definition surgical camera to emphasize the initial intraoperative evaluation with localization of the fistula and diverticulum. We then demonstrate the approach to the dissection with the goal of ensuring complete resection of the diverticulum, fistula, and mesh, while preserving healthy tissue for subsequent closure. The utilization of unique and specialized tools for each portion of the procedure is also illustrated. A layered vaginal closure, including a Martius flap, is created to prevent recurrence.RESULTS:
The surgery was accomplished without complications.CONCLUSIONS:
To our knowledge, concomitant findings of a urethral diverticulum, urethrovaginal fistula, and mesh erosion are unique in the literature. We postulate that this triad could have resulted from the mesh burden in this particular patient.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Telas Cirúrgicas
/
Doenças Uretrais
/
Fístula Urinária
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Fístula Vaginal
/
Divertículo
Limite:
Female
/
Humans
/
Middle aged
Idioma:
En
Revista:
Int Urogynecol J
Ano de publicação:
2024
Tipo de documento:
Article