Summary
Rev Bras Ginecol Obstet. 2003;25(7):525-528
DOI 10.1590/S0100-72032003000700010
PURPOSE: to evaluate the results of the use of bovine pericardium in the pubovaginal sling procedure for treatment of stress urinary incontinence. METHODS: a prospective analysis of five patients who underwent pubovaginal sling with the use of bovine pericardium strip for stress urinary incontinence in the "Hospital das Clínicas of UFMG" from October/2001 to December/2001. The mean age was 48.2±11.5 years (33 to 69 years). RESULTS: the mean surgical time was 45±35.3 min and the mean hospital stay was 36±12.4 h (24 to 48 h). Complications in the periperative or immediate postoperative period did not occur. All patients initially presented satisfactory results with normal voiding and without stress incontinence. Postoperative complications occurred in the 5 patients (100%), with dehiscence of the vaginal wound and total expulsion of the strip in 2 patients (40%) and partial expulsion in 3 patients (60%). All patients presented stress urinary incontinence and were submitted to a new sling procedure using the rectus fascia. The patients then progressed without complications and with improvement of urinary continence in 4 patients (80%). CONCLUSIONS: pubovaginal sling with the use of bovine pericardium was associated with high rates of complications. Therefore, its use is not recommended in the treatment of stress urinary incontinence.
Summary
Rev Bras Ginecol Obstet. 2003;25(7):529-532
DOI 10.1590/S0100-72032003000700011
The fistulas caused by mechanical trauma are rare, mainly the intrinsic type caused by vesical lithiasis. The treatment of these fistulas is controversial, concerning the ideal surgical technique. Several techniques have been developed, including the transvaginal and the transabdominal surgical approaches. The authors report the case of a patient with urinary loss for six months. Physical and radiological examination showed the occurrence of a vesicovaginal fistula caused by vesical lithiasis. The treatment was in two stages: first the extraction of the vesical stone by transabdominal approach and second, the correction of the fistula by transvaginal approach.