Martius Flap Graft
A Martius Flap Graft is used to treat mesh exposure in the vagina. Mesh exposure comes from a TVT or TOT mesh used to treat incontinence or prolapse.
Whilst a Martius Flap Graft is used to treat fistulas it is unproven in treating mesh exposure. Mesh when exposed in the vagina becomes infected and placing a graft over the top leads to failure of the graft.
Complications of the Martius Flap Graft
Complications were limited to bleeding from the flap bed in 19%; hematomas in 5.4%; and lymphorrhea from the labial incision in 13.5% and labial wound infection in 5.4% of cases. It also leads to pain in the labia and loss of sensation leading to sexual dysfunction.
The failure rate of the Martius Flap Graft is high if the mesh under it is infected. This leads to more surgery.
It is also wrong to consider that the labia is just excess skin which can be harvested to use as a graft. The labia minora are two small cutaneous folds 3–4 cm long, situated between the labia majora and extending from the clitoris anteriorly to the fourchette posteriorly.
Anteriorly each labium is divided into two portions: the upper division passes above the glans of the clitoris to fuse with the opposite part and forms the preputium clitoridis; the lower division passes under the clitoris, forming the frenulum of the clitoris with its contralateral part. The labia minora are rich in sebaceous glands, connective tissue, and vascular erectile tissue, with a considerable number of sensory nerve endings and receptors.
To remove such tissue has a direct impact on those glands and nerve endings.
Conclusions
If you have had a Martius Flap Graft complications get in touch with us today. Call Dr Victoria Handley on 0800 470 2009 or email vhandley@handleylaw.co.uk to for helps and advice.