Vesicovaginal fistula

A vesicovaginal fistula can be caused by injury to the urinary tract, which can occur accidentally during surgery to the pelvic area, such as a hysterectomy. It can also be caused by a tumor in the vesicovaginal area or by reduced blood supply due to tissue death (necrosis) caused by radiation therapy or prolonged labor during childbirth.

What are the symptoms?

The most common symptom is constant urine leakage from the vagina. The patient may also experience irritation in the area of the vulva, and frequent urinary tract infections.

How is it diagnosed?

Your doctor may be able to see the vesicovaginal fistula during a visual exam of your vagina. A vesicovaginal fistula can be diagnosed by injecting sterile milk or methylene blue dye through a catheter into the bladder. Your doctor will observe whether the dye progresses through the bladder and into the vagina. Your doctor may also order cystoscopic tests, which are x-rays of the bladder.

What is the treatment?

First, your doctor will treat any urinary tract infections and vulvar irritation. In most cases, vesicovaginal fistulas must be closed surgically. The incision may be made in the abdomen, or the surgeon may repair the fistula through the vagina. If there is tissue death, the surgeon may need to introduce a new blood supply. Following surgery, you may need to wear a catheter for a period of time until the repair has healed completely. Your doctor may prescribe antibiotics to prevent urinary tract infection.

Self-care tips

Surgery to repair a vesicovaginal fistula is usually quite successful. If you have been treated for a vesicovaginal fistula, it is important to follow your doctor’s orders for a complete recovery.