title: Bladder mucosal autograft: An effective method for repair of vesicovaginal fistula.
abstract: BACKGROUND
  To investigate the effectiveness of bladder mucosal autograft for the treatment of vesicovaginal fistulae.
  
  
  METHODS
  Between March 2005 and June 2011, 21 patients with a single vesicovaginal fistula above the trigone, not involving the ureters, underwent surgery. Bladder was approached extraperitoneally and opened in the midline. The mucosa around the fistula was incised and inverting sutures were placed over the fistula opening. The mucosal defect was covered by a free mucosal graft from the edge of cystotomy incision.
  
  
  RESULTS
  After catheter removal at 2 weeks, 18 patients (85 %) remained dry while one patient experienced urge incontinence, which resolved in a few days and another one still had urine leakage (although less than before the operation) that improved after another 3 weeks of bladder drainage. Only in one patient, the operation failed.
  
  
  CONCLUSIONS
  Short duration of hospitalization, simplicity of the procedure, avoidance of extensive bladder dissection, and extraperitoneal nature of the operation, along with a high success rate are the advantages of this procedure. This technique could be recommended for single fistulae not involving the ureters and not secondary to malignancies.
authors: Department of Urology, Tehran University of Medical Sciences, Sina Hospital, Tehran, Iran.
authors: Mohammad G
authors: MG
authors: Mohseni
authors: Seyed R
authors: SR
authors: Hosseini
authors: Farshid
authors: F
authors: Alizadeh
authors: Shahram
authors: S
authors: Gooran
authors: Nadia
authors: N
authors: Valikhani
keywords: Bladder mucosa; graft; vesicovaginal fistula