Treatment by omentoplasty of vesicorectovaginal and rectovaginal fistulae

: In order to close the vesicorectovaginal fistulas (15 cases operated on) or rectovaginal (5 cases operated on) of irradiation origin, the author modifies his classical technique for the omentoplasty of the fistulous orifice, in terms of an obstruction in the upper thirds or the half of the vagina by using the pediculated omentum. The surgery is performed in two surgical times during the same operation: 1. the vaginal time is compulsory as the first surgical time consisting of the avivement the upper part of the vagina by the excision of the vaginal mucosa surrounding the fistulous orifices; 2. the abdominopelvian time consisting of the mobilization of the omentum (Kiricuta's technique), its descending into the pelvis and then, by an extensive cystotomy, the omentum is inserted into the vagina through the vesicovaginal fistulous orifice. The adherence created between the omentum and the vaginal wall free of mucosa, results in the cure of the fistulas. There are presented different technical variants. Out of 20 surgical cases, 18 were cured per primam during 14 days. Only 2 cases died due to peritonitis.