Vesicovaginal fistula is a distressing complication which may follow hysterectomy, prolonged labor, chemical cauterization due to uterine prolapse, radiation therapy and cervix cancer. The management of vesicovaginal fistula still remains
controversial
in regard to the type of approach and timing of repair but the classic opinion is to wait 3 to 6 months to allow the surgical inflammatory reaction to subside.
We experienced 4 cases of vesicovaginal fistula which were as follows;
Case 1: 51-year-old
The vesicovaginal fistula, about 3.0cm in diameter, after laparascopic hysterectomy 15 days ago was repaired with interposition of a gracilis muscle flap via the transvaginal route.
Case 2: 38-year-old
The vesicovaginal fistula, about 2.5cm in diameter, after Cesarean ection 5 years ago was repaired with interposition of the omental flap via the transabdominal route because she had been accompanied by an overian cyst.
Case 3: 46-year-old
The vesicovaginal fistula, about 2.5cm in diameter, after manual self abortion at home 30 years ago was repaired with interposition of fibro-fatty tissue in labia via the transvaginal route.
Case 4: 43-year-old
The vesicovaginal fistula, about 2.0cm in diameter, after prolonged labor 12 years ago was ropaired with interposition of the fibro-fatty tissue in labia via the transvaginal route.
There noted no complications or recurrence during the minimal 1 year follow-up.
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