Small vesicovaginal fistula.

A simple method of curettage of the fistulous tract, using an ordinary metal screw, has been successful in the cure of certain types of vesicovaginal fistulas. This technique applies to small, high, usually postoperative vesicovaginal fistulas in which the tissue appears normal and in which there is good blood supply and no evidence of scarring or inflammatory reaction. By curetting and removing the epithelium of the fistulous tract, the tissues will follow their normal tendency toward healing and a good chance of closure of the fistula is thereby present. The main virtues of this procedure are its simplicity, the minimal risk involved, the short hospitalization time, and the fact that there is no delay in the performance of the standard type of excisional operation in case of failure. Three cases are reported.