[Operative treatment of vesico-vaginal fistulae]

During a period of 16 years, 40 cases of vesico-vaginal fistulae were treated. In 21 of the cases a fistula closing operation could be carried out, 8 vaginally and 13 suprapubically. Out of the 40 cases 19 were cured. In most cases the fistula was approached abdominally and closed by a single-layer method, leaving the vaginal defect open for drainage. This method was suitable for all types of vesico-vaginal fistulae, independent of their size and location but especially suitable for fistulae occurring after irradiation where severe tissue changes had occurred. Urinary diversion is often the only way of helping these patients and the indications for the various types of diversion are discussed.