Mazhar Khan, Saadia Muhammad, Farrukh Ozair Shah, Ravale Tashfeen, Shehla Faridoon, Ainul Hadi, Barka Sajjad.
Role of Modified Martius Flap In The Repair of Vesicovaginal Fistulae.
J Surg Pak Jan ;22(4):143-6.

Objective: To assess the outcome of interpositioning modified Martius flap in repair of vesicovaginal fistulae (VVF) of more than 2cm size. Study design: Descriptive case series. Place & Duration of study: Departments of General Surgery Khyber Teaching Hospital (KTH) and Hayatabad Medical Complex (HMC), from January 1997 to December 2016. Methodology: The case records of the patients were reviewed. All patients who had simple fistulae and those requiring repair through abdominal approach were excluded. All the patients had vaginal examination for confirmation of leakage following which they were subjected to cystoscopy/EUA to assess the number of fistulae their location and tissue scarring. Dye test was also done when needed. IVU, cystogram, urine c/s, were done in all patients. Modified Martius flap repair was performed. Patients were discharged on 3rd postoperative day and followed up for three months. Results: Eighty-one patients underwent modified Martius flap repair for vesicovaginal fistulae. Mean age of the patients was 40 year (range: 20-60 year). Obstructed labor was the main etiological factor in 64 (79.01%) patients followed by gynecological surgeries in 10 (12.34%) patients. Fifty-three (66.25%) patients were operated for recurrent fistula formation. Post surgery 10 (12.34%) patients complained of stress incontinence and were treated conservatively. Vaginal bleeding was noted in 6 (7.40%) and labial wound infection in 4 (4.93%) patients. Recurrence occurred in 7 (8.64%) patients which included 3 (3.70%) patients who were operated upon, for recurrent fistula formation. Conclusion: Modified Martius flap technique is a good treatment option for the management of vesicovaginal fistula with minimal complications and better cosmesis.

PakMediNet -Pakistan's largest Database of Pakistani Medical Journals - http://www.pakmedinet.com