A vesicovaginal fistula is an abnormal connection between the bladder and the vagina. This type of fistula is usually caused by complications of child birth in developing countries. In US they are mostly secondary to trauma, injury or complication of pelvic surgery in women. They may cause pain, bloody vaginal discharge, and urinary incontinence. Many different types of repair is available. If possible Dr. Bonni repairs these using a vaginal approach and if not then laparoscopic or open routes are chosen on a case by case basis. The fistula and the connection is identified and meticulously separated from the surrounding viable organs and tissues. It is then resected and the openings are closed in layers.