Huang William C, Zinman Leonard N, Bihrle William
Department of Urology, Lahey Clinic Medical Center, 41 Mall Road, Burlington, MA 01805, USA.
Urol Clin North Am. 2002 Aug;29(3):709-23. doi: 10.1016/s0094-0143(02)00064-2.
Despite the many controversies surrounding the proper surgical repair of vesicovaginal fistulas, the current methods available allow surgeons to select the procedure best suited for each specific problem. Because each fistula is unique, surgeons will often be required to individually vary their approach and technique. Regardless of whether a transabdominal or transvaginal approach is selected, the concepts of using healthy tissue in tension-free closures and reinforcing the closures in high-risk situations will ensure success nearly all of the time. A urinary diversion should be considered in the rare situation where the fistula has failed even the most technically sound repair.
