Behcet's Disease with Urethrovaginal Fistula and Stress Urinary Incontinence

Seo, Ill Young; Park, Kyung Won; Chung, Hee Jong; Rim, Joung Sik

Abstract

Behcet's disease is a polymorphic and systemic disease involving the urinary tract. The principal manifestations in the urinary system are genital ulcerations. Urethrovaginal fistula is an uncommon disorder, which can result from any condition, like Behcet's disease, associated with pressure necrosis or local tissue ischemia. It presents an operative challenge for the surgeon because it tends to be associated with significant scarring and insufficient surrounding tissues to allow for a tension-free closure. For this reason, the interposition of well-vascularized tissue is necessary to facilitate healing. We experienced a 30-year-old woman with Behcet's disease, who had a large urethrovaginal fistula with stress urinary incontinence. For this patient, we tried combining a dermofat graft pubovaginal sling and a vaginal flap urethral reconstruction. This operative method seemed to be safe and effective for complex and refractory urethrovaginal fistula associated with stress urinary incontinence.