Vesico-vaginal and recto-vaginal fistulae.

In a series of 1138 patients with vesico-vaginal and/or recto-vaginal fistulae, the main cause in the developing world was obstructed labour, and in the developed world was surgery and/or malignancy. Most repairs were performed by a vaginal approach; there was dedicated nursing care; 85% were cured at the first attempt. In the developing world, prevention will require improved access to good obstetric care.