Published in:
01-03-2017 | Original Article
The uses and outcomes of the Martius fat pad in female urology
Authors:
Sachin Malde, Marco Spilotros, Ailsa Wilson, Mahreen Pakzad, Rizwan Hamid, Jeremy Ockrim, P. Julian Shah, Tamsin Greenwell
Published in:
World Journal of Urology
|
Issue 3/2017
Login to get access
Abstract
Purpose
To assess the indications, morbidity, efficacy and outcomes of Martius fat pad (MFP) interposition in reconstructive female urology.
Materials and methods
Data on 159 women with MFP interposition as part of their primary procedure between 2 September 2005 and 2 July 2015 were prospectively collected. Patient demographics and the indications for MFP interposition along with the outcomes of their primary procedures and short- and long-term complications related to the MFP, along with patient reported perception of post-operative appearance, were noted.
Results
The main indications for MFP interposition were urethral diverticulum excision (74), vaginal repair of vesicovaginal fistula (VVF) (43), removal and repair of urethral erosion of mid-urethral tape (MUT) (24), female urethroplasty for stricture (12), vaginal closure of bladder neck for complex end-stage stress urinary incontinence (USUI) (4) and as a MUT wrap for protection of urethra and vagina in women with fragile urethras (2). The majority of patients (127 or 79 %) rated the post-operative appearance of their labia as good or excellent. Only 1 patient (0.6 %) felt the post-operative appearance was unsatisfactory. There were 2 post-harvest labial haematoma (1.25 %), 1 labial wound infection in an overweight diabetic patient (0.6 %) and no other significant short- or long-term complications.
Conclusions
MFP interposition is associated with good cosmesis and a very low complication rate (<2 %). It appears to lower new onset post-procedure USUI, prevent erosion in the ‘fragile’ urethra and improve outcomes following repair of post-surgery VVF/UVF. MFP is a versatile and effective tool in the female urologists’ armamentarium.