[The simplified technic of treatment by omentoplasty of irradiated and injured large vesico-vaginal fistulas. Apropos of 130 surgical cases].

Beginning with 1954, I. Kiricuta suggested and successfully used the stopping of the orifice in the vesico-vaginal fistula by omentum. It is presented the own experience during the last 33 years on 130 surgical cases (50 surgical fistulas, 65 complex vesico-vaginal fistulas on the intense irradiated tissues, 15 fistulas after irradiation as well as neoplastic ones). Of these, 20 cases of vesico-rectovaginal or rectovaginal fistulas operated on very successfully but that raises particular technical problems will be presented in another paper. Two surgical techniques will be here presented: 1. The classical technique: the omentum mobilized, it is the case, following a special technique (fig. 1a, 1b, 1c) is then interposed as a screen between the bladder and the vagina (fig. 2 & 3), that results in the cure of the fistulas due to the fibroblastic features of the omentum. 2. The simplified technique presents the following features: after the wide cystotomy and the excision (freshening) the mucosa of the upper third of the vagina (fig. 5) by the fistulous vesico-vaginal orifice, the vagina is stopped with the descended omentum through the bladder into the vagina (fig. 5 & 6). This last procedures is very easy to perform. By using these techniques the healing was obtained in 100% (there was only one death due to the upper digestive hemorrhage).