Vaginal Repair of Post-Cystectomy Labial Hernia

Salter E1, Schatz A1, Wolff G1, Chang Kit L1

Research Type

Clinical

Abstract Category

Pelvic Organ Prolapse

Abstract 252
Video Session 1 - Reconstruction
Scientific Podium Video Session 13
Wednesday 4th September 2019
18:27 - 18:36
Hall G3
Female Surgery Pelvic Organ Prolapse
1.Albany Medical College
Presenter
L

Laura Chang Kit

Links

Abstract

Introduction
A 61 year old woman presented for consultation for labial bulge status post cystourethrectomy for high grade muscle invasive bladder cancer. She has noted left labial swelling over the past several years, which has worsened with time and become increasingly uncomfortable. Upon exam a 5 cm peri-clitoral bulge herniating through the left labia minora is appreciated. It is easily reducible, but recurs readily. MRI imaging reveals a fat containing left labial hernia.
Design
Patient was counseled, informed consent obtained, and patient brought to the operating room for vaginal hernia repair.
Results
Midline vaginal incision was made. Tissue was significantly scarred and adherent. An enterocele was dissected off the vaginal epithelium. The left labial hernia was dissected and excised. An 8x10cm piece of Polyform mesh was cut to size and secured to ischiopubic rami and perivaginal connective tissues. Further coverage was provided with bilateral Martius flaps. Redundant left labial tissue was excised, improving cosmesis, concluding the procedure. See associated video for further description.
Conclusion
Vaginal repair with synthetic mesh and Martius flaps is a viable option for post-cystectomy labial hernia.
Disclosures
<span class="text-strong">Funding</span> None <span class="text-strong">Clinical Trial</span> No <span class="text-strong">Subjects</span> Human <span class="text-strong">Ethics not Req'd</span> It is a case study, patient consented to presentation of video abstract. <span class="text-strong">Helsinki</span> Yes <span class="text-strong">Informed Consent</span> Yes