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What’s a vesicovaginal fistula?

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Vesicovaginal fistula (VVF) is a condition where urine passes through the vagina due to an abnormal connection between the bladder and vagina. It can be caused by childbirth, pelvic surgery, radiation therapy, or female genital mutilation. Symptoms include urinary incontinence, abdominal expansion, and vulva inflammation. It can be treated with surgery and a Foley catheter may be needed for up to 14 days after treatment.

A vesicovaginal fistula (VVF) is an abnormal connection between the bladder and the vagina. This condition causes urine to pass through the vagina, resulting in increased leakage and incontinence in women. There are a variety of risks to a VFD during childbirth, medical procedures related to the pelvis, or radiation therapy, but it can be treated through surgery.

A VVF results from a lack of blood supply to the tissues of the vagina and bladder. Holes begin to form between the vaginal wall and the bladder, allowing urine to flow out and into the vagina. Urinary incontinence begins to show, as does an increased risk of urinary tract infections and irritation of the vulva. A VVF is a common form of urogenital fistula (UGF), an umbrella term for unnatural connections between two female organs.

One cause of a vesicovaginal fistula is accidental injury to the urinary tract during surgery in the pelvic area, such as a hysterectomy. Tissue damage in the area near the bladder and vagina from radiation therapy is another factor that could cause this condition. A cut made in the anterior wall of the vagina during female genital mutilation, which is practiced in some countries, can also cause VVF. This condition occurs if the cut is too deep and starts to create a hole between the vagina and the bladder.

Obstructed labor during pregnancy is another common cause of vesicovaginal fistula in some countries. The complication results in obstetric fistula, which occurs when there is a restriction of blood flow to the tissues in the birth canal. These tissues are severely damaged, causing the woman to have urinary incontinence.

Obstructed labor also puts women at risk for developing a rectovaginal fistula (RVF), a hole that forms between the rectum and vaginal tissues. These holes allow stool to pass through and into the vagina. This complication can cause stool to leak uncontrollably from the vagina.

Although urine leakage is the most common symptom of a vesicovaginal fistula, expansion of the abdominal area along with irritation or inflammation of the vulva can also indicate a problem. VVF is diagnosed by doing a double-dye test that includes an oral anesthetic and a methylene blue dye. Doctors use a catheter to inject the dye into your bladder or vagina. X-rays are taken during this process to determine if this dye is entering the vagina.
A vesicovaginal fistula is often treated with surgical procedures that repair holes in the vaginal tissue. Patients may need to use a Foley catheter up to 14 days after treatment. Doctors also suggest avoiding sexual intercourse for a minimum of six weeks to allow the healing process to complete.

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