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The evidence of vesicovaginal fistulas is very old. Archeologists found Egyptian mummies that had vesicovaginal fistulas, before the year 2000 B.C. Only approximately 4000 years later, in 1675, Johann Fatio described the first treatment of vesicovaginal fistulas (VVF) successfully 1.
The cause of vesicovaginal fistulas may be acquired or congenital, the last ones being rare
(Table 1). Historically, the obstetric trauma was classified as the main cause of vesicovaginal fistulas. Even today, in most countries in development, the obstetric trauma is prevalent, being responsible for 90% of the cases. On the other hand, childbirth assistance evolved considerably in developed countries and the abdominal total hysterectomy because of benign illnesses has become the most common cause for vesicovaginal fistulas in these countries (70% of the cases)
2,3,4,5.
There still exist different forms of surgical approach of
vesicovaginal fistulas, reflecting on the lack of consensus among surgeons in the definition of the best way of treatment. The use of randomized studies to compare the efficacy among the best form of treatment of vesico vaginal fistulas is particularly difficult, due to the variability of the etiology, localization and experience of the surgeons6.
This article has as its objective to revise the most recent publications on vesicovaginal fistulas, to discuss the different ways of approach and treatment of this illness, besides emphasizing aspects that have been established about it.