Abstract
The treatment of 49 genital fistulae in the past 18 years is reported from the Department of Gynaecology, Alfred Hospital, Melbourne. The series included 32 vesicovaginal fistulae, 15 rectovaginal fistulae and 2 double fistulae. Whilst utilising the accepted principles of fistula closure, the high success rate is believed due, in large measure, to the additional step of grafting which has been used extensively. It is advocated as a most important principle in all genital fistula surgery.

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