A comparative study of martius flap surgical repair versus repair with small intestinal submucosa biomaterial in management of vesicovaginal fistula

Abstract

Vesicovaginal fistula present as a debilitating and stressful condition for women not only in developing countries but as well in other parts of the world. The first recorded reference of vesicovaginal fistulae were made in 1550 BC in ancient Egypt. The etiology of vesicovaginal fistula differs according to the economic state of the countries, where the obstetric labour is the main cause of etiology in developing countries, as a complication of pelvic surgery in non-developing countries. All these factors lead to presence of more than 2 million women complaining of fistula with an increase from 50,000 to 100,000 new cases every year according to the latest records of the world health organization. Martius flap is a well-known surgical technique with good results , its principal depends on creating a musclofascial flap harvested from labium major as an interposing layer to support and provide new blood supply to the already fibrosed area of fistula. Porcine small intestinal submucosa is a new biomaterial that gives healing power and supports the site of Summary  117 repair of vesicovaginal fistula and its results need to be investigated and studied which is the aim of this study. This is a pilot study exploring the application of the porcine small intestinal submucosa (surgisis) in surgical repair of the urinary vaginal fistulae.