Salvage repair of vesicovaginal fistula.

PURPOSE To present the long-term results of failed vesicovaginal fistula repair using flap splitting techniques. MATERIALS AND METHODS Nine women with a previous failed vesicovaginal fistula repair, aged 18 to 69 years, underwent salvage vaginal reconstruction for damaged urethra or bladder, at a five-year interval lasting from 2003 to 2007. Fistulas were repaired using an interposed pediculated vaginal wall flap. RESULTS The repair was successful in all the patients, even in those with rectovesicovaginal fistula or a large vesicovaginal fistula with sphincter damage. CONCLUSION Pediculated vaginal wall flap is an easily-prepared, well-vascularized tissue, which provides long-term favorable outcomes.