Vaginal Approach to Vesicovaginal Fistula

Vesicovaginal fistula is the most commonly encountered sequela of genitourinary trauma. Although the etiology differs between developed and developing countries, the principles of fistula repair must be strictly adhered to for success. Timing and route of repair remain contentious, because of a lack of randomized data. Evaluation and management is dictated by the surgeon's experience. Minimally invasive techniques with laparoscopy and robotic technology are generating wider interest with reduced postoperative morbidity, but a transvaginal technique should be in the arsenal of all pelvic reconstructive surgeons. More research is required to evaluate the optimal surgical route and technique for successful outcomes.