Appendico-vesicostomy in tile management of complex vesico-vaginal fistulae.

Complex vesico-vaginal fistulae (VVFs) continue to complicated prolonged obstructed labour in this country. Recently a young lady presented to us with a huge VVF, associated with loss of the urethra and bladder neck, severe gynaetresia and recto-vaginal fistula. Her VVF was successfully managed by an appendico-vesiscostomy.