Urovaginal fistulas: experience with the management of 41 cases.

In a retrospective analysis the authors have evaluated their experience with the management of urovaginal fistulas in 41 patients. Of them 34 had vesicovaginal, 3 ureterovaginal, 2 urethrovaginal, 1 ureterovesicovaginal and 1 ileovasicorectovaginal fistula. Fistulas occurred most frequently after gynaecological operations for benign and malignant diseases and after radiotherapy. Reconstructive operations were performed in 37 patients, mostly from the vaginal approach. Primary repair of fistulas was successful in 35 patients. In 2 patients reoperation was required. Due to good experience the authors recommend the transvaginal approach, which in their opinion is suitable for repair of the prevailing part of vesicovaginal fistulas.