Transvaginal repair of a vesico-vaginal fistula using a mobilised vaginal flap to form the bladder base: a case report.

We describe a case of a vesico-vaginal fistula in a 32-year-old lady presenting with true urinary incontinence. There was a 1.5 x 1.5 cm deficit in the bladder wall and the left ureteric orifice was very close to the edge of the defect. For a successful transvaginal repair, we used a mobilized vaginal flap to bridge the defect in the bladder wall. This avoided the mobilization of the bladder wall and also prevented the left ureteric orifice from getting entrapped in the suture line. Adjacent wall of vagina was mobilized and stitched over the first layer to achieve water tight repair. Her post operative period was uneventful. The repair healed well and she was discharged in a good condition.