Simple management of difficult vesicovaginal fistulas by anterior transvesical approach.

A simple method to repair vesicovaginal fistulas through an anterior transvesical approach is described. The process involves minimal dissection and mobilization of the bladder mucosa to preserve the blood supply to the area of the fistula. There were 29 patients referred to 1 urology unit treated in this way during the last 10 years, with a success rate of 86 per cent after the first operative attempt.