ABSTRACT
This chapter focuses on non-obstetrical vesicovaginal fistula (VVF) repair. Simple trigonal, bladder neck or urethrovaginal fistula are ideally suited for transvaginal repair given the ease of exposure and improved visibility of the perivesical fascia, along with the availability of vaginal wall or Martius flap for tissue interposition. The chapter reviews minimally invasive treatments, vaginal repairs, tissue interposition options and postoperative management. It is generally believed that urine culture should be assessed preoperatively and any bacterial infection treated to improve the success of repair. Intraoperative exposure of the VVF is critical to a successful, tension-free repair. The Latzko repair does by definition shorten the vaginal length/depth and can be considered ideal in cases of prior failed repair. For more complicated fistulas, or in cases of prior failed repair or radiation a transvaginal multilayered repair with tissue interposition may be performed.
