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Vesicovaginal and Ureterovaginal Fistula - Causes, Symptoms, and Treatment

Published on Sep 23, 2022   -  5 min read


This article explains the causes, symptoms, treatment, and complications of vesicovaginal and urethrovaginal fistulas.


Introduction -

Vesicovaginal and urethrovaginal fistula can be one of the most troublesome complications of obstetric trauma and pelvic surgery. They are abnormal connections between the vagina and other structures. The vesicovaginal fistula is a commonly occurring vaginal fistula, whereas the ureterovaginal fistula occurs rarely.

What Is a Fistula?

A fistula is an abnormal passage or connection between two body parts, such as two organs or blood vessels that do not usually connect. Fistula can occur naturally or due to injury, surgery, radiation, or inflammation. A fistula may develop at any part of the body, however, the most common ones are found around the anus. There are three types of fistula,

What Is a Vaginal Fistula?

A vaginal fistula is an unusual opening or connection that connects the vagina with other structures. There are several types of vaginal fistula that include,

What Are the Causes for Vesicovaginal and Uretrovaginal Fistula?

The most common cause of fistula include:

What Are the Symptoms of Vesicovaginal and Uterovaginal Fistula?

Vesicovaginal Fistula -

Uterovaginal Fistula -

What Is the Treatment for the Ureterovaginal Fistula?

The treatment goals for ureterovaginal fistula are to preserve renal function, prevent or treat urinary sepsis, and cure urinary incontinence. Successful treatment of uterovaginal fistula depends on the time of diagnosis of the disease following the previous surgery, degree of injury to the ureter, site of injury, and time of referral to the urologist.

There are two approaches for treating ureterovaginal fistula:

  1. Conservative management.

  2. Surgical techniques.

1. Conservative Management:

The conservative management is indicated when the fistula is diagnosed early and is small. It is recommended with the expectation of spontaneous closure in the small fistula. Prolonged use of self-retaining bladder catheters is helpful in such cases. Intuitive healing is reported in five percent of women.

2. Surgical Management:

Surgical management is indicated when there is a failure of conservative treatment or in cases with a large fistula. The different approaches for surgical closure of uterovaginal fistula include vaginal, extraperitoneal, or transperitoneal laparotomies; in laparoscopic and robotic procedures, O’Connor’s surgical technique is used to treat uterovaginal fistula. First, the bladder is moved with the dissection of the fistulous tract and the opening of the uterus cavity. Then, using two layers of stitches, the bladder is repaired, and with one layer of suture, the uterus is closed. A vascularized tissue is usually placed to eliminate dead space and prevent hematoma formation.

Complications of ureterovaginal fistula

What Is the Treatment for Vesicovaginal Fistula?

1. Conservative Methods:

2. Surgical Method:

Before surgery, the first step is to treat any infections, inflammation, and necrosis.

The timing of the surgery depends on a few factors like,

There are two surgical approaches, the vaginal approach, and the abdominal approach. The surgeons select the appropriate one depending on the following factors:

3. Laparoscopy Method:

Laparoscopy of the vesicovaginal fistula is done without opening the bladder and uses an intracorporeal suture (sutures done within the body). It fastens the postoperative recovery and reduces the hospital stay.


Vesicovaginal and uterovaginal fistula have distressing complications due to continuous leaks of urine. Despite good surgical techniques and preventive measures, these injuries can still occur. Therefore, appropriate and spontaneous management can be beneficial.

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Last reviewed at:
23 Sep 2022  -  5 min read




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