Radiation-Induced Recurrent Vesicovaginal Fistula-Treatment with Adjuvant Platelet-Rich Plasma Injection and Martius Flap Placement-Case Report and Review of Literature

Int J Environ Res Public Health. 2021 May 3;18(9):4867. doi: 10.3390/ijerph18094867.

Abstract

Vesicovaginal fistula is the non-physiological connection between the urinary bladder and vagina. This results in continuous urine leakage. In developed countries, the prevalence of this condition is low and affects (mainly) women with a history of gynaecological procedures or radiotherapy. The aim of this study was to present the therapeutic process of a patient with radiation-induced, recurrent vesicovaginal fistula. The thirty-eight-year-old patient underwent radical hysterectomy with follow-up radiotherapy due to cervical cancer. Five years after the therapy, she was diagnosed with vesicovaginal fistula. After two unsuccessful Latzko procedures and two adjuvant platelet-rich plasma injections, a third Latzko reconstructive surgery was performed with additional transposition of the Martius flap-with successful closure of the fistula.

Keywords: Martius flap; incontinence; platelet-rich plasma; radiation; urogenital fistula; vesicovaginal fistula.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adult
  • Female
  • Humans
  • Hysterectomy
  • Platelet-Rich Plasma*
  • Surgical Flaps
  • Uterine Cervical Neoplasms* / surgery
  • Vesicovaginal Fistula* / etiology
  • Vesicovaginal Fistula* / surgery