Background: Operative laparoscopy was performed for the management of
ovarian remnant syndrome involving the bladder, bowel, vagina, and ure
ters, and requiring extensive dissection. A vesicovaginal fistula deve
loped postoperatively. Case: Because of the complexity and location of
the fistula, a vaginal approach was not appropriate. Using techniques
of videolaparoscopy, videocystoscopy, and operative laparoscopy, the
fistula was repaired. Conclusion: In experienced hands, endoscopic man
agement of complex vesicovaginal fistulas may be an alternative to the
traditional abdominal approach.