Failed omental flap vesicovaginal fistula repair subsequently repaired laparoscopically without an omental flap.

BACKGROUND Conventional wisdom suggests that vascular interposition flaps are helpful in the treatment of all patients with vesicovaginal fistulas. Complicated fistulas are often treated with interposition omental flaps; however, failed omental flap repairs have not been described without the use of another interposition flap. CASE A 52-year-old woman with a history of cystotomy repair at the time of hysterectomy and a subsequent abdominal omental flap vesicovaginal fistula repair failure underwent a successful repair using a laparoscopic-layered closure of her fistula without omental flap. CONCLUSION A failed omental flap vesicovaginal fistula repair can be repaired laparoscopically and without an omental flap.