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Midurethral autologous fascial sling surgery with reconstruction of the lower abdominal wall using the tensor fascia lata muscle flap for post‐hemipelvectomy stress urinary incontinence
Authors:Aya Niimi  Yasuhiko Igawa  Tetsuya Fujimura  Motofumi Suzuki  Makoto Mihara  Isao Koshima  Yukio Homma
Affiliation:1. Department of Urology, The University of Tokyo Graduate School of Medicine, , Tokyo, Japan;2. Department of Continence Medicine, The University of Tokyo Graduate School of Medicine, , Tokyo, Japan;3. Department of Plastic and Reconstructive Surgery, The University of Tokyo Graduate School of Medicine, , Tokyo, Japan
Abstract:Hemipelvectomy is surgery for pelvic bone neoplasms. In the case of pubic bone osteosarcoma, the distal end of the rectus abdominis muscle is severed from the pubic and ischium bones, and the pelvic floor muscles are resected en bloc with the bone, which leads to stress urinary incontinence. Cancer control is prioritized over complications, and stress urinary incontinence is generally disregarded. A 25‐year‐old woman presented with stress urinary incontinence. She had undergone a hemipelvectomy for left pubic bone osteosarcoma, and stress urinary incontinence appeared and persisted since the surgery. We carried out a reconstruction of the tissue deficit of the rectus abdominis using the tensor fascia lata muscle flap simultaneously with a midurethral autologous fascial sling anchoring to the tensor fascia lata flap. Stress incontinence was successfully improved without morbidity. This is the first reported case of midurethral suspension with reconstruction of the lower abdominal wall with the tensor fascia lata flap for post‐hemipelvectomy stress urinary incontinence.
Keywords:fascial sling  hemipelvectomy  stress urinary incontinence
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