We appreciate the editorial comment regarding our report: "A Modified Surgical Technique for Treatment of Radiation-Induced Vesicovaginal Fistulas." We could not agree more regarding the 5 "commandments" to be considered when managing vesicovaginal fistulas. When considering the fifth commandment added by the commentator, it can be translated as: "When looking at the reconstructive ladder, do not use every step from the bottom to the top. Convert it into a lift and go straight to the optimal level."
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