Vesicovaginal fistula repair—Revisited☆

Abstract Successful closure of a vesicovaginal fistula in scarred and irradiated tissue is very difficult. Unless additional vascularity can be brought to the repair site, failure is inevitable. The bulbocavernosus fat pad serves as an ideal pedicled blood supply to revascularize the fistula repair site and when combined with effective postoperative bladder decompression, a successful closure rate of 90% can be anticipated.