Abstract

There is a misconception that post hysterectomy supratrigonal vesicovaginal fistula (VVF) are “high” and cannot be treated with vaginal approach and require to be dealt with abdominally (either open or laparoscopy/robotics). This, however, is not true as a surgery was described more than a century ago just for this indication, ‘the Latzko repair’. The alternative name “partial colpocleisis”, is a misnomer and has contributed a long way in preventing this approach from becoming popular. Other vaginal approaches which can deal with vault fistulas are vaginal cuff excision approach and the conventional flap splitting approach. This article attempts to bring the vaginal approaches (Latzko in particular) to the forefront in the management of post hysterectomy supratrigonal vault VVF.