Novel use of the rectus abdominus muscle flap for vaginal reconstruction in complex obstetric fistula repair: A case series

BJOG. 2024 Aug 8. doi: 10.1111/1471-0528.17926. Online ahead of print.

Abstract

Objective: Globally, obstetric fistula is a tragic outcome following obstructed labour. Failure of complex repair and post-operative incontinence are common. We describe an innovative surgical technique incorporating the rectus abdominus flap at the time of fistula repair.

Design: Retrospective case series.

Setting: Malawi, Fistula Care Centre.

Methods: Patients were followed for 3 months after discharge to determine continence and healing.

Results: Five of six patients were continent at 3 months and one was lost to follow-up by dry at a one month post-operative phone call. There were no major complications.

Conclusions: The rectus abdominus flap may be a useful adjunct to repair of complex obstetric fistula.

Keywords: obstetric fistula; plastic surgery; rectus muscle flap; vesicovaginal fistula.