Simultaneous repair of post-irradiation vesicovaginal and rectovaginal fistulas

A simultaneous repair of radiation-induced vesicovaginal and rectovaginal fistulas is suggested. Creation of a diverting colostomy must be the preliminary procedure. Both fistulas are closed simultaneously several months later. The vesicovaginal fistula is closed with a rotated flap from the apex of the bladder and is reinforced additionally with omentopexy. The rectovaginal fistula is closed by pulling the descending colon through the rectal stump with its mucosa stripped off. The operation was performed with good results on a 42-year-old patient with grade II cervical carcinoma in whom fistulas developed after combined treatment by radiotherapy and an operation.