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The main therapeutic modality of vesicovaginal fistula is surgery. Despite this, in special situations, conservative procedures may be tried, which consist in continuous vesical drainage with the Foley catheter and an antibiotic therapy for 3 or 4 weeks. This approach may be useful in selected cases of small post-hysterectomy fistulas. After this period a spontaneous closing of the fistula does not easily occur. The success of this conservative therapy is approximately restricted to 10% of all the cases of vesicovaginal fistulas 5,11,12.
Another conservative modality for the treatment of the vesicovaginal fistulas is electro coagulation of the course of small and non-complicated fistulas. The idea of this therapy is to destroy the epithelium of the fistula keeping the patient under continuous vesical catheterization, in the attempt that the cicatrisation process should occlude the fistulous course.
The obtained results with this modality generally are not adequate. 5,12