[Usage of acellular dermal matrix allograft in surgical treatment of vesico-vaginal fistula and anterior urethral stricture: report of 9 cases].

OBJECTIVE

To assess the value of acellular dermal matrix allograft (ADMA) in surgical treatment of vesico-vaginal fistula (VVF) and anterior urethral stricture.

METHODS

Four patients suffering from vesico-vaginal fistula and 5 cases with long anterior urethral stricture received surgical treatment in which ADMA were applied. In the VVF patients the ADMA inserted between the vagina and the bladder during transabdominal extraperitoneal repair. In the patients with anterior urethral stricture the ADMA was sutured to substitute the urethra after resection of the stenosis segment.

RESULTS

No intraoperative or postoperative complications occurred. Immediate stoppage of urine leakage from the vagina was seen in the 4 VVF patients, and no recurrence was found during the follow-up of 4 - 12 months. Satisfactory voiding was achieved immediately after removing the catheter in 3 of the 5 cases of urethral stricture, although 2 of the 5 needed urethral sounding for about 2 months. Three months postoperatively all patients were voiding well and their urine flow rates were all normal. Urethrography revealed excellent caliber of the reconstructed urethra.

CONCLUSION

In plastic surgery of lower urinary tract such as for VVF and urethra stricture, the ADMA may serve as an ideal replacement material for autologous tissue. Its usage avoids the need to harvest autologous tissue, thus providing a novel, safe, effective, microinvasive and economic method in urologic plastic surgery.