Significant obstetric-related pelvic floor injury is still all too common in many areas of the world. Vesicovaginal fistula formation typically results from obstructed labor in the setting of limited medical resources for the patient. Many people have dedicated their time and even their lives to repairing these types of pelvic floor injuries, which certainly can impact in a positive way on the quality of life of these suffering women. However, it is time to consistently combine surgical repair initiatives with education, training, and prevention strategies, as well as outcomes research in order to improve on these efforts. It is only through committed initiatives with all of these elements that we may be able to ultimately decrease the prevalence of these types of pelvic floor sequelae. © International Urogynecology Journal 2006.