Review of experience with vesicovaginal fistula repair.

Experience with suprapubic closure of vesicovaginal fistulas in 42 patients considered candidates for this procedure is reviewed. Five patients required a second operation for cure and the reasons for failure are discussed. Wide exposure with tension-free closure of well vascularized flaps and the judicious interposition of pedicled omentum have produced the most encouraging results. The litigious nature of this distressing condition is lessened when primary closure is successful and supravesical diversion by ileal or colonic conduits can be avoided.