{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,14]],"date-time":"2026-04-14T23:20:47Z","timestamp":1776208847302,"version":"3.50.1"},"reference-count":11,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2017,11,17]],"date-time":"2017-11-17T00:00:00Z","timestamp":1510876800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2018,5]]},"abstract":"<jats:sec><jats:label\/><jats:p>Our aim was to describe a new surgical method for prophylaxis\/cure of post obstetric fistula repair leakage based on restoring vaginal elasticity with Singapore skin flap. The rationale for this operation was based on the integral theory: scarring removes elasticity required for independent function of oppositely acting urethral closure forces so they become \u2018tethered, forcibly opening the urethra when give the signal to close'. Skin graft restores elasticity and closure. Used prophylactically with Goh type 4 fistula (<jats:italic>n<\/jats:italic> = 45), 46% were dry against an expected 19%. In patients with successful fistula closure, still with severe leakage (<jats:italic>n<\/jats:italic> = 24), 71% were dry against an expected 26%.<\/jats:p><\/jats:sec><jats:sec><jats:title>Tweetable abstract<\/jats:title><jats:p>Singapore skin flap restores elasticity and prevents and treats incontinence in patients with successful obstetric fistula repair.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1471-0528.14953","type":"journal-article","created":{"date-parts":[[2017,10,11]],"date-time":"2017-10-11T06:42:36Z","timestamp":1507704156000},"page":"745-749","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["Skin flap vaginal augmentation helps prevent and cure post obstetric fistula repair urine leakage: a critical anatomical analysis"],"prefix":"10.1111","volume":"125","author":[{"given":"A","family":"Browning","sequence":"first","affiliation":[{"name":"Maternity Africa Arusha Tanzania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"G","family":"Williams","sequence":"additional","affiliation":[{"name":"Ministry of Health Addis Ababa Ethiopia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"P","family":"Petros","sequence":"additional","affiliation":[{"name":"Professorial Unit Department of Surgery St Vincent's Hospital Clinical School University of NSW, Sydney Sydney NSW Australia"},{"name":"School of Mechanical Engineering University of Western Australia Crawley WA Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2017,11,17]]},"reference":[{"key":"e_1_2_11_2_1","first-page":"2","article-title":"(Editorial) Towards a solution for obstetric fistula problems","volume":"36","author":"Browning A","year":"2017","journal-title":"Pelviperineology"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00192-010-1202-5"},{"key":"e_1_2_11_4_1","first-page":"727","article-title":"The use of modified Martius graft as an adjunctive technique in vesicovaginal and rectovaginal fistula repair","volume":"75","author":"Elkins TE","year":"1990","journal-title":"Obstet Gynecol"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijgo.2006.01.003"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0412.1990.tb08027.x"},{"key":"e_1_2_11_7_1","first-page":"48","article-title":"Post vesico\u2010vaginal fistula repair incontinence \u2013 a new hypothesis and classification potentially guide prevention and cure pelviperineology","volume":"34","author":"Petros PEP","year":"2015","journal-title":"Pelviperineology"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-642-03787-0_4"},{"key":"e_1_2_11_9_1","first-page":"100","article-title":"Tethered vagina syndrome: cure of severe involuntary urinary loss by skin graft to the bladder neck area of vagina","volume":"29","author":"Goeschen K","year":"2010","journal-title":"Pelviperineology"},{"key":"e_1_2_11_10_1","first-page":"9","article-title":"Prevention and cure of post vesico\u2010vaginal fistula repair incontinence by insertion of skin graft in the bladder neck area of vagina \u2013 update on hypothesis and interim report","volume":"36","author":"Browning A","year":"2017","journal-title":"Pelviperineology"},{"key":"e_1_2_11_11_1","first-page":"85","article-title":"The free graft procedure for cure of the tethered vagina syndrome","volume":"153","author":"Petros PE","year":"1993","journal-title":"Scand J Urol Nephrol"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00192-003-1112-x"}],"container-title":["BJOG: An International Journal of Obstetrics &amp; 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