[Repair of a complex vesicovaginal fistula using a musculocutaneous flap of the gracilis muscle].

Effective repair of an obstetrical vesicovaginal fistula was obtained using an original technique, after five unsuccessful operations. The method involves removal of a pediculated musculo-aponeurotic flap from the internal surface of the thigh using the gracilis muscle. The flap is passed through a subcutaneous tunnel to a position facing the loss of bladder substance: the muscular surface of the flap is oriented towards the detrusor while the cutaneous portion is sutured to the vaginal wall. This technique should be used more widely for vesicovaginal fistulae with great loss of substance.