Introduction and hypothesis: Vesicovaginal fistula (VVF) is a distressing urologic disorder. We describe a new technique that adds a third layer of closure during vaginal repair of VVF. Methods: Twenty female patients with low VVF were included. A circumferential incision was made around the fistula that was completely excised. A rectangular vaginal flap was created just proximal to the site of the fistula. After closure of the urinary bladder, the distal edges of the vaginal flap were dissected and it was mobilized and interposed between the bladder and the vagina. Then the vagina was closed. Results: The mean follow-up was 16±9 months. All of the patients are dry. None of them had any added morbidity due to the procedure. There are no postoperative complications. Conclusions: Vaginal flap reinforcement during vaginal repair of VVF is a simple and effective technique with high success rate and no added complications.
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