ABSTRACT
To assess the causes of Vesico-vaginal fistula and evaluate the results of surgical repair ot'Vesico-vaginal fistula A retrospective study was conducted in Ch and ka Medical College Hospital and Larkan Medical Centre from March 1999 to February 2005. Forty patients of Vesico-vaginal fistula resulting from causes other than malignancies and radiations were included in the study. Majority of the patients had fistula secondary to an obstetrical cause. Of the total 32 patients were repaired trans-vaginally. Prolonged labour was the major cause of Vesico-vaginal fistula [80%]. Thirty two [80%] patients were operated trans vaginally and 8 trans-abdominally. Success rate was 85.8% for the transvaginal approach in the first instance. Stress urinary incontinence was noted in 2 patients while 1 patient with transabdominal approach developed recurrence. In developing countries the major cause of Vesico-vaginal fistula is obstructed labour which can be repaired trans. vaginally in majority of cases under skilled surgeon