Lufkin Urologist Performs First-of-its-kind Surgery

VVFurologyThrough a first-of-its-kind surgical procedure, a Lufkin urologist has given quality of life back to an Angelina County woman and hopes to provide others with the same kind of relief. Using an innovative procedure, an amniotic membrane and robotic technology at CHI St. Luke’s Health Memorial, Dr. David Price, a board certified urologist, successfully repaired a complex bladder problem in a way no one has done before.

After being diagnosed with cervical cancer in 2014, Julia Hardin, 66, suffered for more than six months from constant, uncontrollable urinary incontinence following a complete hysterectomy, chemotherapy and radiation. The embarrassment, odor and stress were taking a toll on the Huntington woman.

“I didn’t want to go anywhere; I couldn’t go anywhere because I was always worried about leaking,” Hardin said. “I have a son, and he’s into football and taekwondo. I wanted to go, sit and watch him like any other mom, but I was always self-conscious.”

The patient had developed a vesicovaginal fistula (VVF).  A VVF is a hole located between the bladder and vaginal wall allowing a continuous involuntary discharge of urine. VVFs can cause emotional trauma and severe inconvenience. Nearly 1 percent of all women diagnosed with gynecological cancer develop these devastating conditions, and complex VVFs are by nature some of the most difficult cases that urologists and gynecologists encounter.

“Due to the internal damage done by radiation, there were only few treatment options to repair the one-centimeter hole and none proved very successful,” said Dr. Price.

“The high failure rate of these kinds of repairs for patients like Mrs. Hardin is primarily caused by the destructive effects of radiation which results in poor wound healing,” said Dr. Price. “This surgical repair is known to be a complicated procedure with significant morbidity and a high rate of failure due to the effect of radiation.”

However, after much research and dedication to finding a solution, Dr. Price invented a procedure never before performed on this kind of condition. The veteran surgeon used a fragile, dehydrated amniotic human membrane as a graft to patch the hole and assist in wound healing. The graft was put into place utilizing the da Vinci robotic system at CHI St. Luke’s Health Memorial on June 2. According to Dr. Price, to his knowledge, no one has ever attempted and succeeded at performing a VVF repair after radiation, and no one has used an amniotic membrane to repair a defect like this.

On June 2, Dr. David Price (left), board certified urologist, used the da Vinci surgical robot to place a fragile, dehydrated amniotic human membrane to patch a hole between Julia Hardin’s (right) bladder and vaginal wall, resolving months of constant, uncontrollable urinary incontinence. The procedure was a first-of-its-kind, invented specifically for Hardin’s complex situation. (Photo: CHI St. Luke's Health Memorial)

On June 2, Dr. David Price (left), board certified urologist, used the da Vinci surgical robot to place a fragile, dehydrated amniotic human membrane to patch a hole between Julia Hardin’s (right) bladder and vaginal wall, resolving months of constant, uncontrollable urinary incontinence. The procedure was a first-of-its-kind, invented specifically for Hardin’s complex situation. (Photo: CHI St. Luke’s Health Memorial)

Dr. Price reports there were no operative or postoperative complications, and Hardin was discharged the first day after surgery. Three weeks later, an imaging procedure demonstrated total healing.

Open surgical approaches have been the preferred procedure to repair VVFs for more than 50 years; however, they can be associated with significant morbidity and can result in prolonged hospitalization. While the benefits of minimally invasive surgical techniques in decreasing morbidity and hospital length of stay are well recognized, there have been few attempts to utilize these techniques, Dr. Price said.

“The da Vinci surgical robot provided improved visualization and technical advantages which allowed the procedure to be performed successfully,” Dr. Price added. “Human amniotic membranes have been used for decades on a variety of difficult to heal wounds. The membranes act as a barrier and promote tissue growth.”

Ms. Hardin said because of Dr. Price’s dedication, she’s gotten her dignity back and hopes this will pave the way for others like herself.

“I’m still feeling great. I hope this works for everyone like it did for me,” Hardin said. “I want this to be a stepping stone for others to be able to have a life they can be proud of.”

About CHI St. Luke’s Health Memorial

Memorial provides more than a quarter of a million patient services each year and has a longstanding history of providing quality, innovative health care in East Texas.

With hospitals in Lufkin, Livingston, San Augustine and Memorial Specialty – the area’s only long-term acute care hospital – CHI St. Luke’s Health Memorial provides millions of dollars in charity care and community support each year.  Our mission is to nurture the healing ministry of the Church, supported by education and research.  Fidelity to the Gospel urges us to emphasize human dignity and social justice as we create healthier communities.

Memorial offers a wide array of services, including the area’s first dedicated heart and stroke care facility and radiation oncology at the Temple Cancer Center. It is also known for the area’s only comprehensive diabetes, heart and stroke education center. Other specialty areas include imaging, orthopedic care, women’s services, inpatient and outpatient rehabilitation, homecare, wound care and hyperbaric oxygen therapy, kidney & diabetes treatment, sleep disorders treatment and express lab.

About Catholic Health Initiatives

Catholic Health Initiatives, a nonprofit, faith-based health system formed in 1996 through the consolidation of four Catholic health systems, expresses its mission each day by creating and nurturing healthy communities in the hundreds of sites across the nation where it provides care. One of the nation’s largest health systems, Englewood, Colo.-based CHI operates in 19 states and comprises 105 hospitals, including four academic health centers and major teaching hospitals and 30 critical-access facilities; community health-services organizations; accredited nursing colleges; home-health agencies; and other facilities that span the inpatient and outpatient continuum of care.

In fiscal year 2014, CHI provided $910 million in charity care and community benefit – a nearly 20% increase over the previous year – for programs and services for the poor, free clinics, education and research. Charity care and community benefit totaled more than $1.7 billion with the inclusion of the unpaid costs of Medicare. The health system, which generated revenues of almost $13.9 billion in fiscal year 2014, has total assets of $21.8 billion. Learn more at www.catholichealthinitiatives.com.

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