Vesicovaginal Fistula: Symptoms, Causes, Treatment
الناسور المثاني المهبلي
A vesicovaginal fistula is an abnormal connection between the bladder and vagina that allows urine leakage through the vagina. It differs from ordinary incontinence and is treatable with specialist care.
What is Vesicovaginal Fistula?
Leakage may continue despite normal urination and appear after surgery or childbirth. Other urinary fistulas involve the ureter or urethra, so the exact tract must be identified.
Related reading: Other forms of female urinary incontinence.
Symptoms
Persistent wetness, vaginal urinary leakage, skin irritation, urine odor or discharge may occur. Urinary infections or painful intercourse can accompany it.
Causes
Pelvic surgical injury, obstructed childbirth, radiation or local disease may cause it. Leakage alone cannot establish the precise cause or responsibility.
Risk factors
Pelvic procedures, obstructed labor and previous radiation are important risk factors. Pelvic-floor exercises alone cannot be assumed to close an anatomical fistula.
Diagnosis
Assessment includes history, examination and selected dye testing or cystoscopy. Imaging may evaluate the tract and ureters because treatment depends on anatomy.
Treatment
Selected small, early fistulas may close with catheter drainage, but many need surgical repair. Timing and technique depend on tissue condition, cause and specialist assessment.
Complications
Skin irritation, urinary infection and psychological or social distress may develop. Complex fistulas may need more than one intervention; continued care and support matter.
Prevention
Appropriate maternity care and follow-up after pelvic surgery support early recognition. Use gentle skin care and follow prescribed catheter instructions.
When to see a doctor
Seek specialist review for new persistent leakage, particularly after surgery or childbirth. Fever, flank pain, vomiting or systemic deterioration requires urgent assessment.