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

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.