The treatment of vesicovaginal fistula by endoscopic injection of fibrin glue.

Creation of a vesicovaginal fistula (VVF) is a complication seen in a variety of patients from prolonged labour and elective hysterectomies to advanced gynaecological malignancies. Causing distressing symptoms such as a loss of continence and vulval excoriation, conventional teaching has always advocated an open surgical approach as described by Sims in 1852. This however may not be feasible in cases of advanced malignancy or attractive to the post-operative patient. In this article the case of a 46-year-old lady with a VVF following elective hysterectomy is discussed. She was successfully managed with endoscopic closure of her fistula with fibrin glue.