{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T03:40:06Z","timestamp":1792381206674,"version":"4.4.0"},"reference-count":56,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2024,3,28]],"date-time":"2024-03-28T00:00:00Z","timestamp":1711584000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2024,3,28]],"date-time":"2024-03-28T00:00:00Z","timestamp":1711584000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["bjui-journals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJU International"],"published-print":{"date-parts":[[2024,9]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To present the contemporary evidence on transvaginal urogenital fistulae (UGF) repair with\u00a0Martius fat pad (MFP), compared to direct graftless fistula repair.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We reviewed all available studies reporting lower UGF repair via the transvaginal approach in MEDLINE, Embase, and Cochrane Central Register of Controlled Trials (CENTRAL). The primary outcome of interest was the fistula closure rates. When available, patients\u2019 baseline characteristics, indications for surgery, and early and late postoperative complications with focus on MFP\u2010related complications are reported.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results and Discussion<\/jats:title>\n                    <jats:p>In obstetric fistulae, tissue interposition has been almost completely abandoned, with contemporary large series reporting closure rates of &gt;90% with graftless repair, even for complex fistulae. Similarly, most simple, non\u2010irradiated iatrogenic fistulae can be closed safely without or with tissue interposition with success rates ranging between 86% and 100%. However, MFP is valuable in fistulae with difficulty achieving tension\u2010free and layered closure, with significant tissue loss, urethral involvement and with poorly vascularised tissues after radiotherapy, with reported success rates between 80% and 97% in those challenging situations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>A UGF repair should be individualised after considering the specific characteristics and complexity of the procedure. MFP interposition is probably unnecessary for the majority of low (obstetric) fistulae within otherwise healthy tissues. However, MFP may still have a place to maximise outcomes in low\u2010income settings, in select cases with higher (iatrogenic) fistulae, and in most cases with radiotherapy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/bju.16350","type":"journal-article","created":{"date-parts":[[2024,3,28]],"date-time":"2024-03-28T05:04:37Z","timestamp":1711602277000},"page":"365-374","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["The utility of Martius fat pad in the repair of urogenital fistulae: review of current evidence"],"prefix":"10.1111","volume":"134","author":[{"given":"Konstantinos","family":"Kapriniotis","sequence":"first","affiliation":[{"name":"Department of Urology University College London Hospital (UCLH)  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ioannis","family":"Loufopoulos","sequence":"additional","affiliation":[{"name":"Department of Urology University College 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