OBJECTIVE: To follow-up the quality of life outcomes in 2 women who underwent a modified Mainz II pouch procedure for refractory vesicovaginal fistulas. METHOD: Two Nigerian patients were located after undergoing a modified Mainz II pouch procedure. They were interviewed 1-2 years postprocedure regarding subsequent sexual function, pregnancy outcomes, and daily life. RESULT: After undergoing the procedure the patients had resumed sexual function, had become pregnant, and had delivered viable neonates. They were also able to provide for their families. CONCLUSION: A urinary diversion procedure for management of refractory vesicovaginal fistula can restore quality of life.