{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,6]],"date-time":"2026-03-06T06:28:06Z","timestamp":1772778486594,"version":"3.50.1"},"reference-count":7,"publisher":"Springer Science and Business Media LLC","issue":"6","license":[{"start":{"date-parts":[[2024,5,11]],"date-time":"2024-05-11T00:00:00Z","timestamp":1715385600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,5,11]],"date-time":"2024-05-11T00:00:00Z","timestamp":1715385600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Int Urogynecol J"],"published-print":{"date-parts":[[2024,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Introduction and hypothesis<\/jats:title>\n                <jats:p>This video illustrates a rare surgical case involving a urethral diverticulum, urethrovaginal fistula, and mesh erosion.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>We present a 58-year-old patient attending a tertiary care center with a suspected urethrovaginal fistula. Her concerns included stress urinary incontinence (SUI), recurrent urinary tract infection, and vaginal pain. The surgical history was notable for the placement of two different mesh slings during the same procedure to treat SUI. Preoperative evaluation and findings are illustrated in detail. The video uses a high-definition surgical camera to emphasize the initial intraoperative evaluation with localization of the fistula and diverticulum. We then demonstrate the approach to the dissection with the goal of ensuring complete resection of the diverticulum, fistula, and mesh, while preserving healthy tissue for subsequent closure. The utilization of unique and specialized tools for each portion of the procedure is also illustrated. A layered vaginal closure, including a Martius flap, is created to prevent recurrence.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>The surgery was accomplished without complications.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>To our knowledge, concomitant findings of a urethral diverticulum, urethrovaginal fistula, and mesh erosion are unique in the literature. We postulate that this triad could have resulted from the mesh burden in this particular patient.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00192-024-05787-3","type":"journal-article","created":{"date-parts":[[2024,5,11]],"date-time":"2024-05-11T13:01:47Z","timestamp":1715432507000},"page":"1327-1329","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Surgical Approach to Urethral Diverticulum and Urethrovaginal Fistula With Mesh Erosion"],"prefix":"10.1007","volume":"35","author":[{"given":"Alicia","family":"Smith","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lauren","family":"Burton","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Saifuddin","family":"Mama","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2024,5,11]]},"reference":[{"issue":"5","key":"5787_CR1","doi-asserted-by":"publisher","first-page":"523.e1","DOI":"10.1016\/j.ajog.2019.09.006","volume":"221","author":"A Berger","year":"2019","unstructured":"Berger A, Tan-Kim  J, Menefee SA. Surgeon volume and reoperation risk after midurethral sling surgery.  Am J Obstet Gynecol. 2019;221(5):523.e1\u20138. https:\/\/doi.org\/10.1016\/j.ajog.2019.09.006.","journal-title":"Am J Obstet Gynecol"},{"issue":"5","key":"5787_CR2","doi-asserted-by":"publisher","first-page":"822","DOI":"10.1590\/S1677-5538.IBJU.2016.0250","volume":"43","author":"C Gomes","year":"2017","unstructured":"Gomes C, Carvalho FL, Bellucci CHS, et al. Update on complications of synthetic suburethral slings. Int Braz J Urol. 2017;43(5):822\u201334. https:\/\/doi.org\/10.1590\/S1677-5538.IBJU.2016.0250.","journal-title":"Int Braz J Urol"},{"key":"5787_CR3","doi-asserted-by":"publisher","first-page":"6761581","DOI":"10.1155\/2020\/6761581","volume":"2020","author":"E Pacer","year":"2020","unstructured":"Pacer E, Duenas-Garcia  OF, Hota  L, Hornsby  K, Shapiro  R. Urethral diverticulum following polypropylene mesh midurethral slings: a literature review. Biomed Res Int. 2020;2020:6761581. https:\/\/doi.org\/10.1155\/2020\/6761581.","journal-title":"Biomed Res Int"},{"issue":"2","key":"5787_CR4","doi-asserted-by":"publisher","first-page":"129","DOI":"10.4103\/0970-1591.98453","volume":"28","author":"H Shah","year":"2012","unstructured":"Shah H, Badlani GH. Mesh complications in female pelvic floor reconstructive surgery and their management: a systematic review. Indian J Urol. 2012;28(2):129\u201353. https:\/\/doi.org\/10.4103\/0970-1591.98453.","journal-title":"Indian J Urol"},{"issue":"3 Suppl","key":"5787_CR5","doi-asserted-by":"publisher","first-page":"S1350","DOI":"10.1016\/j.ajog.2021.12.248","volume":"226","author":"Z Cope","year":"2022","unstructured":"Cope Z, Francis, S, Warehime J, Feroz R, Lenger S. Surgical repair of urethral diverticulum with superimposed urethrovaginal fistula using a Martius flap. Am J Obstet Gynecol. 2022;226(3 Suppl):S1350. https:\/\/doi.org\/10.1016\/j.ajog.2021.12.248.","journal-title":"Am J Obstet Gynecol"},{"key":"5787_CR6","doi-asserted-by":"publisher","first-page":"e1","DOI":"10.1016\/j.urology.2020.04.073","volume":"141","author":"W Lee","year":"2020","unstructured":"Lee W, Uberoi P, Coy DL, Lee UJ. Erosion of mesh mid-urethral sling into a complex urethral diverticulum: diagnosis, evaluation, and surgical management. Urology. 2020;141:e1\u20132. https:\/\/doi.org\/10.1016\/j.urology.2020.04.073.","journal-title":"Urology"},{"issue":"Suppl 2","key":"5787_CR7","doi-asserted-by":"publisher","first-page":"S81","DOI":"10.21037\/tau.2017.04.38","volume":"6","author":"A Wilson","year":"2017","unstructured":"Wilson A, Pillay  S, Greenwell  T. How and why to take a Martius labial interposition flap in female urology. Transl Androl Urol. 2017;6(Suppl 2):S81\u20137. https:\/\/doi.org\/10.21037\/tau.2017.04.38.","journal-title":"Transl Androl Urol"}],"container-title":["International Urogynecology Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00192-024-05787-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00192-024-05787-3\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00192-024-05787-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,7,12]],"date-time":"2024-07-12T14:03:30Z","timestamp":1720793010000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00192-024-05787-3"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,5,11]]},"references-count":7,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2024,6]]}},"alternative-id":["5787"],"URL":"https:\/\/doi.org\/10.1007\/s00192-024-05787-3","relation":{},"ISSN":["0937-3462","1433-3023"],"issn-type":[{"value":"0937-3462","type":"print"},{"value":"1433-3023","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,5,11]]},"assertion":[{"value":"17 December 2023","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"27 March 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"11 May 2024","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"None.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflicts of interest"}},{"value":"Written informed consent was obtained from the patient for\u00a0\u00a0publication of this video article and any accompanying\u00a0\u00a0images.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}}]}}