An alternative in surgical treatment of post-irradiation vesicovaginal and rectovaginal fistulas: the seromuscular intestinal graft (patch).

Abstract

The excellent results experienced with the use of seromuscular intestinal grafts in certain types of urological plastic operations encouraged us to use it (as a patch) also in the surgical management of vesicovaginal and rectovaginal fistulas. With this method, we treated 4 patients with post-irradiation fistulas who had previously undergone 1 or 2 operations. The seromuscular intestinal graft served as a direct partial wall replacement of the bladder or rectum. At the same time, it also supported the nutrition of the compromised tissues surrounding the fistula. There were no complications with epithelialization of the denuded muscular surface of the seromuscular intestinal graft (patch) facing into the bladder.