Vesicovaginal and ureterovaginal fistulas: a review of 39 cases.

The aim of this retrospective study was to present our experience in the treatment modalities of patients with vesicovaginal and ureterovaginal fistula. Between 1987 and 1997, 39 patients were diagnosed and operated on for vesicovaginal and ureterovaginal fistula. Of these patients, 31 had vesicovaginal, 7 had ureterovaginal and 1 had both vesicovaginal and ureterovaginal fistula. The ureterovaginal fistulas were repaired by simple ureteroneocystostomy with 100% success. Vesicovaginal and urethrovaginal fistulas were repaired transvaginally in 7 cases, transabdominally in 23 cases and endoscopically in two cases with 77% success at first attempt and 92% success with several attempts. The successful repair of urinary tract fistulas can be achieved in the majority of cases by adhering to the basic surgical principles. The optimum approach is that which works best in the surgeon's hands.