[Operative treatment of vesico-vaginal fistulae in the University Hospital, Lomé (Togo, West Africa) (author's transl)].

This publication draws attention to the importance of knowing about the existence of vesico-vaginal fistulae with or without disturbance of normal sphincteric control of the bladder. The repair procedure and avoidance of urinary incontinence after successful anatomical closure of the fistulae depends on the preoperative assessment of sphincteric function. A classification is presented in schematic form of the various types of vesico-vaginal fistulae with the appropriate surgical method of choice, according to our experience in this field, to obtain optimum functional results. In particular, our own operative procedure for substitution of absent sphincteric bladder control is detailed and discussed. Finally, attention is drawn to the balloon catheter test and the possibility of obtaining improvement in the surgical management of vesico-vaginal fistulae by a combination and modification of established operative procedures.