{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,5]],"date-time":"2025-12-05T09:48:08Z","timestamp":1764928088032,"version":"3.46.0"},"reference-count":16,"publisher":"BMJ","issue":"12","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2025,11,8]]},"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:p>Vesicovaginal fistula (VVF) is one of the most common iatrogenic complications of pelvic surgery. Giant VVFs reported in the literature that were successfully repaired were done transabdominally or using a combination of different approaches. This study presents a giant VVF that was successfully repaired transvaginally. This is a case of a female who came in for continuous vaginal leakage which presented 3 weeks after a total hysterectomy. Physical examination revealed a 6.0\u00d73.0\u2009cm vaginal defect. The patient underwent Latzko repair of vesicovaginal fistula with peritoneal flap interposition. The patient had a successful repair and remained continent for 13 months on follow-up. Fistula size alone may not necessarily be a single determinant in the route of fistula repair. With surgical experience and other complex factors ruled out, successful vaginal repair of giant vesicovaginal fistulas proves to be possible.<\/jats:p>","DOI":"10.1136\/bcr-2025-267641","type":"journal-article","created":{"date-parts":[[2025,12,5]],"date-time":"2025-12-05T09:45:18Z","timestamp":1764927918000},"page":"e267641","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Vaginal repair of a complex supratrigonal vesicovaginal fistula"],"prefix":"10.1136","volume":"18","author":[{"given":"Maria Margarita Franchesca Concepci","family":"Lojo","sequence":"first","affiliation":[{"name":"Division of Urogynecology and Pelvic Reconstructive Surgery, Department of Obstetrics and Gynecology, University of the Philippines-Philippine General Hospital, Manila, Philippines"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ira Dominique 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