A report of thirty-four instances of urethrovaginal and bladder neck fistulas. 
The current study was done to outline problems noted by an individual surgeon in his experience with the management of urethrovaginal and bladder neck fistulas.  Twenty-six women with intact urethras distal to the fistulas had transvaginal layered closures.  Five women with completely destroyed posterior urethral walls had transvaginal reconstructions.  Three women with special findings had individualized surgical repairs.  Successful function, as well as anatomic results, were obtained in 23 of 26 women in the first group, two of five women in the second group and all three women in the third group.  An uncomplicated urethrovaginal or bladder neck fistula may be repaired successfully by a transvaginal layered closure.  The repair of a complicated fistula, one which is radiation-induced or one in which the entire posterior urethra has been destroyed, may result in functional failure despite an apparently successful anatomic result.  The method by which bladder drainage after fistula operation is performed does not effect the result.