A scoping review of tissue interposition flaps used in vesicovaginal fistulae repair

Background: Research on the use of tissue interposition flaps (TIFs) in vesicovaginal fistulae (VVF) repair is a broad area where a very wide range of natural and synthetic materials have been used. The occurrence of VVF is also diverse in the social and clinical settings, resulting in a parallel he...

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Main Authors: Halime Serinçay, Hayrullah Uğur Güler, Kezban Ulubayram, Naşide Mangır
Format: Article
Language:English
Published: SAGE Publishing 2023-06-01
Series:Therapeutic Advances in Urology
Online Access:https://doi.org/10.1177/17562872231182217
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author Halime Serinçay
Hayrullah Uğur Güler
Kezban Ulubayram
Naşide Mangır
author_facet Halime Serinçay
Hayrullah Uğur Güler
Kezban Ulubayram
Naşide Mangır
author_sort Halime Serinçay
collection DOAJ
description Background: Research on the use of tissue interposition flaps (TIFs) in vesicovaginal fistulae (VVF) repair is a broad area where a very wide range of natural and synthetic materials have been used. The occurrence of VVF is also diverse in the social and clinical settings, resulting in a parallel heterogeneity in the published literature on its treatment. The use of synthetic and autologous TIFs in VVF repair is not yet standardized with a lack of the most efficacious type and technique of the TIF. Objectives: The aim of this study was to systematically review all synthetic and autologous TIFs used in the surgical repair of VVFs. Data sources and methods: In this scoping review, the surgical outcomes of autologous and synthetic interposition flaps used in VVF treatment meeting the inclusion criteria were determined. We searched the literature using Ovid MEDLINE and PubMed databases between 1974 and 2022. Study characteristics were recorded, and data on the change in fistulae size and location, surgical approach, success rate, preoperative patient evaluation and outcome evaluation were extracted from each study independently by two authors. Results: A total of 25 articles that met the inclusion criteria were included in the final analysis. A total of 943 and 127 patients who had received autologous and synthetic flaps, respectively, were included in this scoping review. The fistulae characteristics were highly variable with regard to their size, complexity, aetiology, location and radiation. Outcome assessments of fistulae repair in included studies were mostly based on symptom evaluation. Physical examination, cystogram and methylene blue test were the methods in order of preference. Postoperative complications, such as infection, bleeding, donor site, pain, voiding dysfunction and other complications, were reported in patients after fistulae repair in all included studies. Conclusion: The use of TIFs in VVF repair was common especially in complex and large fistulae. Autologous TIFs appear to be the standard of care at the moment, and synthetic TIFs were investigated in prospective clinical trials in a limited number of selected cases. Evidence levels of clinical studies evaluating the effectiveness of interposition flaps were overall low.
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spelling doaj.art-598091c1354947d9ba68ec22cac2ecf22023-06-26T17:03:41ZengSAGE PublishingTherapeutic Advances in Urology1756-28802023-06-011510.1177/17562872231182217A scoping review of tissue interposition flaps used in vesicovaginal fistulae repairHalime SerinçayHayrullah Uğur GülerKezban UlubayramNaşide MangırBackground: Research on the use of tissue interposition flaps (TIFs) in vesicovaginal fistulae (VVF) repair is a broad area where a very wide range of natural and synthetic materials have been used. The occurrence of VVF is also diverse in the social and clinical settings, resulting in a parallel heterogeneity in the published literature on its treatment. The use of synthetic and autologous TIFs in VVF repair is not yet standardized with a lack of the most efficacious type and technique of the TIF. Objectives: The aim of this study was to systematically review all synthetic and autologous TIFs used in the surgical repair of VVFs. Data sources and methods: In this scoping review, the surgical outcomes of autologous and synthetic interposition flaps used in VVF treatment meeting the inclusion criteria were determined. We searched the literature using Ovid MEDLINE and PubMed databases between 1974 and 2022. Study characteristics were recorded, and data on the change in fistulae size and location, surgical approach, success rate, preoperative patient evaluation and outcome evaluation were extracted from each study independently by two authors. Results: A total of 25 articles that met the inclusion criteria were included in the final analysis. A total of 943 and 127 patients who had received autologous and synthetic flaps, respectively, were included in this scoping review. The fistulae characteristics were highly variable with regard to their size, complexity, aetiology, location and radiation. Outcome assessments of fistulae repair in included studies were mostly based on symptom evaluation. Physical examination, cystogram and methylene blue test were the methods in order of preference. Postoperative complications, such as infection, bleeding, donor site, pain, voiding dysfunction and other complications, were reported in patients after fistulae repair in all included studies. Conclusion: The use of TIFs in VVF repair was common especially in complex and large fistulae. Autologous TIFs appear to be the standard of care at the moment, and synthetic TIFs were investigated in prospective clinical trials in a limited number of selected cases. Evidence levels of clinical studies evaluating the effectiveness of interposition flaps were overall low.https://doi.org/10.1177/17562872231182217
spellingShingle Halime Serinçay
Hayrullah Uğur Güler
Kezban Ulubayram
Naşide Mangır
A scoping review of tissue interposition flaps used in vesicovaginal fistulae repair
Therapeutic Advances in Urology
title A scoping review of tissue interposition flaps used in vesicovaginal fistulae repair
title_full A scoping review of tissue interposition flaps used in vesicovaginal fistulae repair
title_fullStr A scoping review of tissue interposition flaps used in vesicovaginal fistulae repair
title_full_unstemmed A scoping review of tissue interposition flaps used in vesicovaginal fistulae repair
title_short A scoping review of tissue interposition flaps used in vesicovaginal fistulae repair
title_sort scoping review of tissue interposition flaps used in vesicovaginal fistulae repair
url https://doi.org/10.1177/17562872231182217
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