Seromuscular vascularized ileal loop patch for the repair of radiation induced vesico-vaginal fistula after radical hysterectomy for cervical carcinoma

ABSTRACT

The use of Vascularized pedicled seromuscular Heal loop patch as a well Vascularized interposition tissue flap, between bladder and vaginal walls for repair of radiation induced vesico-vaginal fistula -was studied on nine patients from the period of April 2000 till January 2003 in the national cancer institute. Those patients were referred to the surgical department with adiagnosed vesico-vaginal fistula, that developed after completion of an external beam and intracavitary radiotherapy post hysterectomy for cervical carcinoma. Through transabdominal, Transvesical approach, with stinting of the ureters during dissection of the fistulous tract, an ileal loop flap is mobilized with its mesenteric blood supply to become technically amenable for enforcement of the repair or reconstruction of the deficient vesical wall after excision of the scarred fistulous tract simulating cystoplasty technique. The outcome of this approach and flap technique showed successful healing of all fistulae in all patients, without complications either post operatively or during follow up. This study recommended the use of seromascular Vascularized Heal loop patch for the repair of radiation induced vesico-vaginal fistula after radical hysterectomies