Complicated Vesico-Urethravaginal Fistula

We report a case of complicated urethravesicovaginal fistula of 15 years. A 50 year old woman presented with continous urine leakage after her last delivery 15 years previously and carried out at home. She had a small and contracted bladder with a urethravesicovaginal fistula. We developed a vaginal flap which was constructed as a tube to make a new urethra. The new urethra from vaginal tube was anastomosed to the repaired bladder base and the external urethral meatus. The reconstruction was supported by Martius flap. Simple anatomic repair of complicated fistulas are not promising and should be avoided. Vaginal flaps and labial flaps are useful for reconstructing urethra and bladder base.