The location of the fistula hole is an important factor in determining the surgical route. The ureteral ridge of the bladder is the boundary, and the posterior bladder triangle above the ureteral ridge is the high level vesicovaginal fistula, and in principle the transabdominal route is used. Fistulas below the ureteral ridge in the bladder triangle, bladder neck, and urethra are low vesicovaginal fistulas, which are mostly done by the transvaginal route. For complex urethral fistulas that are difficult to repair by a single transabdominal or transvaginal route, a combined transabdominal-vaginal route can be chosen. Currently, the main vesicovaginal fistulas treated in our urology department are high vesicovaginal fistulas, which are repaired using the laparoscopic transabdominal route. Most vesicovaginal fistulas are complications of previous surgery, poor tissue conditions near the fistula, disorganized anatomy, and a narrow perineal-pelvic space, which significantly limits the space for surgical operation. Our department adopts the laparoscopic approach to avoid large incisions that can be made in open surgery, and at the same time, it can better deal with narrow areas that are difficult to operate in open surgery and reduce the trauma caused by local tissue separation, etc., which greatly improves the success rate of surgery and shortens the postoperative recovery time. The success rate of laparoscopic surgery for repairing high vesicovaginal fistula has reached more than 80% since our department started.