New surgical approach for treatment of complex vesicovaginal fistula.

Complex vesicovaginal fistulas still represent a management problem, since most of the cases have been operated on previously and because of the lack of a completely successful surgical technique. A new procedure for vesical autoplasty is presented. A flap is obtained from the posterosuperior bladder wall that slides down to cover large lesions, even in low capacity reservoirs. The technique has shown excellent long-term results in 42 consecutive complicated cases.