Transvesical vesicovaginal fistula repair: a revival

Vesicovaginal fistulae are usually traumatic in nature, following obstetric or gynecologic trauma. Here, our experience with vesicovaginal fistula repair in 68 cases, performed transvesically (58 cases) or transperitoneally-transvesically, with pedicled omental interposition in 10 cases over the last 8 years is described. The size of fistulae ranged from 1 to 5 cm, and most were situated near or above the trigone. Two cases required ureteric reimplantation. Recurrent fistulae were found in 4 cases. We attribute our success to the simple access, the construction of a vascularized flap, the tension-free grid-iron closure, and the utilization of Vicryl suture.