Transvaginal repair of the posthysterectomy vesicovaginal fistula using a peritoneal flap: the gold standard.

OBJECTIVE

To evaluate the transvaginal approach to management of vesicouterine fistulas.

STUDY DESIGN

Over a 10-year period, 7 cases of simple posthysterectomy vesicovaginal fistulas were identified. The surgical technique involved resection of the fistulous tract completely, performance of layered closure and placement of a peritoneal flap between the bladder and vaginal suture lines.

RESULTS

One fistula closed spontaneously, and the remaining 6 were repaired transvaginally. Primary repair was successful in all cases, with no complications.

CONCLUSION

The transvaginal repair described is the preferred method of repair, associated with an extremely high success rate, low morbidity and cost savings. Its approach should be considered the gold standard.