Closure of large vesicovaginal fistulas by transplantation of the bladder wall

With large defects in the bottom of the urinary bladder, extensive adhesions of the edges of the fistulas directly with the bony walls of the pelvic floor, or with fixation of the uterus posteriorly, resp. to the sides, as well as in the absence of the anterior lip of the vaginal part or the lower part of the uterus with an existing utero-cystic fistula, it is possible to use the Trendelenburg method to close the defects, transplant a flap from the opposite fistula of the vaginal wall, or release the bladder over a large extent from surrounding parts and apply for transplantation of the wall of the urinary bladder itself.