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Vesicovaginal and ureterovaginal fistulas are abnormal openings that connect the urinary system to the vagina, causing involuntary leakage of urine. A vesicovaginal fistula is a passage between the bladder and the vagina, leading to continuous urine leakage through the vagina. A ureterovaginal fistula connects the ureter (the tube that carries urine from the kidney to the bladder) to the vagina, causing similar urinary leakage issues.

Causes and Symptoms

These fistulas most commonly result from gynecological surgeries, radiation therapy, obstetric trauma, or prolonged obstructed labor. Symptoms include continuous or intermittent urine leakage, vaginal irritation, infections, and emotional distress due to the social and hygienic impact.

Diagnosis and Treatment

Diagnosis involves clinical evaluation, cystoscopy, imaging tests, and dye tests to confirm the fistulous connection. The primary treatment is surgical repair, which usually has a high success rate. Repair can be performed transvaginally, abdominally, or laparoscopically, depending on the fistula’s size and location. Without treatment, these fistulas cause persistent leakage and significant quality-of-life issues.