Management of Radiationinduced Vesicovaginal Fistula

Vesicovaginal fistula caused by radiation therapy can be repaired as previously described, provided that the tissues are well-vascularized. The placement of nonirradiation tissues between the bladder and vaginal closure is required. When radiation-induced VVF is associated with radiation necrosis and fibrosis, mobilization of vascular pedicles is required. Vascular sources may include muscles such as the gluteus maximus or rectus abdominis, or a labial or omental flap. Before attempting repair, recurrent malignancy must be ruled out by biopsy of affected tissues.

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