Complicated postirradiation vesicovaginal fistula in young women: keep off or try reconstruction?

Abstract

Repairing postirradiation vesicovaginal fistula is challenging because the fistula is surrounded by poorly vascularised and fibrotic tissue. An additional problem occurs when intravaginal brachytherapy has caused fibrosis of the vagina. A one-stage technique was used for reconstruction of the vagina and fistula repair in three patients. The omentum and the sigmoid were used to enhance vascularisation and to create a neovagina. At a mean follow-up of 11 mo all patients are continent and report satisfactory sexuality. Using the omentum and the sigmoid is a valuable technique to repair vesicovaginal fistula and to reconstruct the vagina in a one-stage procedure.