Introduction: Vesicovaginal fistulas (VVF) can develop following obstetric trauma, pelvic or vaginal surgery, or radiation therapy. They result in urinary incontinence and recurrent urinary tract infections. Conservative therapy is often not curative, and surgical resection of the fistula tract can be invasive. We present two cases of VVF treated with local injection of an acellular matrix product in an office-based setting.
Objectives: To report the outcomes of transvaginal VVF repair with MatriStem porcine urinary bladder micromatrix (ACell Inc., Columbia, MD, USA) in an office-based setting. No financial funding was utilized in this case report.
Methods: Retrospective chart review was performed on two patients with a single, small (3mm) vesicovaginal fistula that developed following gynecologic surgery. Patients underwent injection of the vesicovaginal fistula tract and surrounding bladder mucosa in an office setting.
Results: Two patients underwent above described procedure in clinic. Cystography 3 weeks after the procedure demonstrated closure of the fistula tract. A single-dye pad test was performed to confirm these findings given small fistula size and was negative in both patients. Both women had resolution of continuous urinary incontinence. Conclusions: MatriStem micromatrix appears to be a promising product in the treatment of small vesicovaginal fistulas, and a potential alternative to more invasive procedures. Additionally, it can safely and readily be performed in an office-based setting.
Clinical Relevance: Reconstruction
Feb 25 2014 - Mar 1 2014
Society of Urodynamics, Female Pelvic Medicine & Urogenital Reconstruction