African Journal of Urology (Oct 2020)

Autologous rectus fascia sling for post-vesicovaginal fistula repair stress incontinence: case series from a Nigerian experience

  • Olatunji Okikiola Lawal,
  • Sadiya Nasir,
  • Oluwasomidoyin Olukemi Bello,
  • Rukiyat Adeola Abdus-salam,
  • Imran Oludare Morhason-Bello,
  • A. M. El-ladan,
  • Oladosu Akanbi Ojengbede

DOI
https://doi.org/10.1186/s12301-020-00060-7
Journal volume & issue
Vol. 26, no. 1
pp. 1 – 6

Abstract

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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.

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