Closure of severe vesico-vagino-rectal fistulas using Lehoczky's island flap.

Thirty large vesico-vaginal and vesico-vagino-rectal fistulas developing after severe radiation injury were closed using Lehoczky's island flap. The pedicle flap of skin and adipose tissue was taken from the area bordered by the greater lip of the pudendum, the perineum and the thigh. It received its blood supply from the internal pudendal artery. Urinary or faecal diversion was not performed. Healing was satisfactory in all 30 patients and there was no recurrence of the fistula.