Consecutive Vesicovaginal Fistula for Transobturator Sling Perforations and Successful Repairs With Skin Flap

Aim: To report a reconstructive technique of large vesicovaginal fistula repairs, which is a rare complication of the most modern anti-incontinence procedures (tension-free tapes) using the "oldie but goodie" Lehoczky's island flap. Methods: Women with large vesicovaginal fistulas caused by mid-urethral transobturator tape were operated in our department. The transobturator tape was removed and the large fistula was closed using the skin island flap. The flap was created from the regional skin and subcutaneous tissue and pulled with intact vascular supply through a paravaginal tunnel to the site of the vaginal defect. Results: No complications occurred after the reconstructions. The patients have become permanently continent and free from fistulas. Conclusions: Mid-urethral transobturator sling is a successful procedure evidenced worldwide with a very low rate of fistula formation. Lehoczky's island flap can be a reasonable and safe surgical option in the repair of large defects of the vaginal wall. Neurourol. Urodynam. 30:1530-1532, 2011. (C) 2011 Wiley Periodicals, Inc.