Transvaginal repair of vesicovaginal fistula using a peritoneal flap.

Even complex vesicovaginal fistulas may be repaired transvaginally. In difficult repairs adjunctive measures have been described to increase the success rate of surgery, including Martius flaps, labial flaps or gracilis muscle flap. We describe a new technique to repair difficult vesicovaginal fistulas via a transvaginal approach.

The Raz bladder neck suspension in patients 65 years old and older.

We reviewed the charts of 92 women 65 years old and older (mean age 72 years, range 65 to 87 years) who underwent the Raz bladder neck suspension between January 1984 and June 1990 for stress urinary incontinence. Mean followup was 17 months. Overall, a successful outcome (cure or rare stress urinary incontinence not requiring protection) was achieved in 81 patients (88%).

Transvaginal repair of enterocele.

The urologist actively involved in the treatment of female genitourinary disease must to be able to recognize and treat various forms of pelvic prolapse. Enterocele is commonly seen in conjunction with stress urinary incontinence and cystocele or it may result from surgery to correct these problems. Many techniques to correct enterocele have been developed, including transvaginal repairs as well as intra-abdominal procedures such as the Moschcowitz technique or colpofixation to the sacrum for enterocele with vault prolapse.

The Raz bladder neck suspension: results in 206 patients.

We reviewed the charts of 206 patients who underwent the Raz bladder neck suspension between January 1984 and June 1990 for stress urinary incontinence. Mean followup was 15 months. Overall, our results demonstrated a successful outcome (cure or rare stress urinary incontinence not requiring protection) in 186 of 206 patients (90.

Morbidity associated with indwelling internal ureteral stents after shock wave lithotripsy.

Placement of internal ureteral stents before extracorporeal shock wave lithotripsy of large stone burdens has decreased the incidence of post-extracorporeal shock wave lithotripsy colic, secondary endoscopic procedures and prolonged hospital stays. However, indwelling stents have an associated patient morbidity and intolerance. A telephone survey of 50 patients (average stone burden 28 mm.