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This can occur due to various factors including: Stomach stretching over time, allowing increased food intake Metabolic adaptation , where the body adjusts to lower calorie intake Behavioural factors , such as return to previous eating patterns Hormonal changes that may affect appetite regulation For patients experiencing inadequate weight loss or significant weight regain after gastric sleeve, GLP-1 receptor agonists may provide additional support

A longitudinal incision was made in the posterior wall of the bladder and the anterior wall of the vagina, 4 mm in length, creating a vesicovaginal fistula using a single-layer technique with single sutures