Simple management of difficult vesicovaginal fistulae by the anterior transvesical approach.

A simple method of repairing vesicovaginal fistulae through an anterior transvesical approach is described. The process involves a minimal dissection and mobilization of the mucous membrane of the bladder in order to preserve the blood supply for the area of the fistula. Twenty-nine patients referred to one Urology Unit have been treated in this way over the past 10 years with a success rate of 86% after the first operative attempt.