Free bladder mucosal autograft in the treatment of complicated vesicovaginal fistula.

Abstract

To describe an effective and simple method for repairing complicated vesicovaginal fistula using a free bladder mucosal autograft. The study included 14 patients with an iatrogenic vesicovaginal fistula after hysterectomy or prolonged obstructed labour. An initial fistula repair had been attempted in 12 patients. All patients were then repaired using a free bladder mucosal graft technique 3-24 months (mean 8) after the fistula was diagnosed. Of the 14 patients 12 had an immediately successful result, with no evidence of leakage, but two required prolonged catheter drainage. Thirteen patients remained dry at the follow-up 3-15 months later. Two patients had stress urinary incontinence and three patients had urinary tract infection. The free bladder mucosal autograft technique is a simple, effective and fast method for vesicovaginal fistula repair. The technique produces an excellent repair of complicated vesicovaginal fistula, and appears to be more physiological and easier to perform than other transabdominal techniques.