Nondelayed transvaginal repair of high lying vesicovaginal fistula.

The management of vesicovaginal fistula still remains controversial in regard to the timing of repair and type of approach. A total of 16 patients underwent transvaginal repair of simple nonradiated vesicovaginal fistulas. In 7 patients the repairs were less than 3 months after the injury, while in 9 the delay was greater than 3 months. A total of 14 patients had high lying lesions (fistulas above the trigone) and 2 had low lying lesions (fistulas below the trigone). Of the 16 patients 15 (94%) stopped leaking after a transvaginal repair. All 7 patients with high lying lesions who underwent operative repair less than 3 months after injury were dry. We advocate early nondelayed repair of high and low lying simple nonradiated vesicovaginal fistulas using the transvaginal approach. The customary waiting period of 3 to 6 months before repair may not be warranted.