Treatment options depend on several things including your medical condition/history, the cause and the location of the stricture. Options for repair include a vaginal or an abdominal approach. The goal of either approach is to excise or close the fistula tract and put healthy tissue in between the bladder and vaginal to help prevent the fistula from recurring.
A vaginal vesicovaginal fistula repair is done through an incision in your vagina. It involves removing the entire fistula with the surrounding scar tissue and then closing the hole in several layers. The surgery takes approximately three hours and can be done under spinal or general anesthesia. There are no stitches or bandages that have to be removed. All the stitches will dissolve on their own.
We do need to have a catheter draining your bladder for 3 weeks following the repair to allow the urethral to heal. We usually use a foley catheter (a catheter placed via your urethra), but may sometimes opt to use a suprapubic tube (the catheter is placed in your bladder via your lower abdomen right above your pubic bone).