Editorial comment

摘要

The authors are to be congratulated for compiling the largest series in the world of bladder neck obstruction in women in just 6 short years. And with large numbers come more complications. But are they preventable? What can be done to minimize them? Vesicovaginal fistula occurred in approximately 5% of the first 63 women who underwent bladder neck incision at the 5- and 7-o'clock position, but in none of the remaining patients who had incisions at the 2- and 10-o'clock position. In both techniques, "the circular fiber was cut from the bladder neck to the fat layer outside of the bladder." Four additional women developed sphincteric incontinence (5%). In our judgment, both these complications are due, not to the orientation of the incisions, but rather to their depth and length. We routinely use the 5- and 7-o'clock incisions and have not encountered either complication.