Surgical repair of a vesicovaginal fistula guided by a black braided silk suture line.

The purpose of the study was to evaluate the effect of the identification of the margins of a vesicovaginal fistula (VVF) during its repair by passing a black braided silk suture line through the fistula. During the repair of a VVF, a suture line was placed through the fistula. By passing the suture line from the vagina through the fistula tract into the bladder and hence to the outside through the urethral meatus, the circumference of the VVF opening can be easily identified after dissection and excision of the vaginal wall around the fistula opening. There were four VVF patients who underwent a modified Latzko procedure using the thread to guide surgical repair. The operation times and blood loss were 45-90 min and no more than 50 ml, respectively. This trick provides adequate identification of the fistula tract, thus permitting safe and easy fistula repair for a narrow, deep, or atrophic vagina.