What is Vesicovaginal Fistula?

Vesicovaginal fistula (VVF) is an abnormal opening between the bladder and the vagina that results in continuous and unremitting urinary incontinence.

Causes of vesicovaginal fistula

1. Postsurgical

2. Abdominal hysterectomy

3. Vaginal hysterectomy

4. Anti-incontinence surgery

5. Anterior vaginal wall prolapse surgery (e.g., colporrhaphy)

6. Vaginal biopsy

7. Bladder biopsy/endoscopic resection/laser

8. Other pelvic surgery (e.g., vascular, rectal)

9. External trauma (e.g., penetrating, pelvic fracture, sexual)

10. Radiation therapy

11. Advanced pelvic malignancy

12. Infectious/inflammatory

13. Obstetric

14. Obstructed labor

15. Trauma

16. Uterine rupture

17. Congenital(rare, associated with urogenital malformations)

Acquired causes of Vesicovaginal Fistula are divided as-

1. Obstetric

2. Surgical

3. Radiation therapy

4. Malignant -Advanced pelvic malignancy (cervical, vaginal, and endometrial carcinoma)

Most common cause (>75 %) of VVF :

1. Injury to the bladder during

2. Gynecologic surgery

3. Urologic surgery

4. Other pelvic surgery. 

5. Surgical injury to urinary tract

Symptoms of vesicovaginal fistula

1. Watery discharge from vagina followed by normal voiding

2. Signs of Vesicovaginal Fistula

3. Continuous urine incontinence after pelvic operation

How do you Diagnose Vesicovaginal Fistula

1. Size and site of fistula is evaluated before surgery  

2. Significant leukocytosis

Confirmatory diagnosis: To diagnose urinary incontinence, urinary bladder is filled with a blue dye solution called methylene blue and then a tampon is inserted inside vagina. The ambulated patient confirms the diagnosis.

Cystoscopy confirms anatomic origin of Vesicovaginal Fistula

1. In case of diagnosing small fistulas, a small ureteric catheter is passed through the fistula (suspected) to check its entry into vagina.

2. Urinary leakage may also be confirmed by checking creatinine levels if they are abnormally high

3. Transvaginal sonography- To look for the size, site, and course of vesicovaginal fistula. 

Vesicovaginal fistulas treatment

Patients suffering from VVF should immediately consult expert gynecologist for further surgical management.

For early VVFs that are non cancerous and minute, conservative treatments are opted

Catheter- Catheter can be placed to manage symptoms and  medications can be taken to prevent movements of involuntary muscles.

Electrocoagulation- This procedure useselectrical current to produce heat that help in removing innermost layer or mucosal layer present in and around the VVF. Subsequently, a catheter is placed and left for some time until healing.

Vesicovaginal fistulas surgery

In cases where conservative treatments don’t work, several surgical management techniques are applicable, like:

Laparoscopic surgery

Laparoscopic surgery- an alternative treatment strategy  in place of open surgery

Method: Surgery is performed by inserting catheter (a small tube) along with a small camera through a small opening made by  a small incision.

Robotic surgery

This type of surgery make use of robotic tool assisting the doctor.

Transvaginal

In a transvaginal surgery, vaginal route is followed for the subsequent treatment. Example include: Latzko repair

Open transabdominal surgery

In this surgery, an open incision is made in abdomen to go for fistula treatment.

Transurethral endoscopic surgery

Urethral path is followed in transurethral endoscopy to repair vesicovaginal fistula.

Note: In vesicovaginal fistula repair, the urine leakage from the abnormal opening is repaired to prevent further leakage and eventually stop the urine incontinence. In case, there are more damages to the urinary bladder, some of the additional treatment procedures may be opted.

Vaginal Fistula Complications

Physical complications of a rectovaginal fistula may include:

1. Fecal incontinence (Uncontrolled loss fecal/stool loss)

2. Recurrent infections in  urinary tract or vagina

3. Irritation in the intimate regions

4. Inflammation of vagina, perineum or the skin around your anus

5. Infected fistula forming abscess (collection of painful pus)

6. Fistula recurrence

Note: If vesicovaginal fistula develops in women suffering from Crohn’s disease, the complications become high leading to poor healing and fistula recurrence.

How do you Prevent Vesicovaginal Fistula

Some of the ways to prevent a vesicovaginal fistula are:

1. Proper antenatal care – For women with obstructed labor adequate care should be given and if needed a cesarean can be planned.

2. Long-standing obstructed labor – In case of obstructed labor that is persisting for longer time, drainage of urinary bladder should be done continuously for 5-7 days after childbirth or delivery.

3. Avoid any kind of bladder injury while performing pelvic surgery.

Why choose Glamyo Health for Vesicovaginal fistulas treatment

1. Glamyo Health is known for its Quick procedure and quick Discharge.

2. Hassle free procedure is undertaken in single day and eventually the same day, the individual gets discharge

3. Glamyo Health has the most advancded facility for the Vesicovaginal fistulas surgery with modernised and least invasive equipment accompanied by experts in their fields.

4. Glamyo provides free Follow-Ups any time anywhere, offline as well as online from the comfort of patient’s home.

5. Glamyo has numerous doctors having expertise in their specialities. Patients may have as many follow as they need.

6. Glamyo has most affordable treatment options and facilities competing the corporate hospitals.

7. Easy Insurance Coverage by the Glamyo Health team to manage and ensure surgical procedures in the hassle-free manner

Painless Procedures with cutting edge advanced equipment

1. Glamyo provides painless surgical options without incisions, stitches, or wounds in comparison to traditional procedures for the surgery

2. Glamyo also provides free drop to the patients and even free pick fro their homes or offices

Frequently Asked Questions

What is a Vesico vaginal fistula?

VVF or vesicovaginal fistula is an abnormal opening located between walls of vagina and bladder. As a result of this abnormal opening, urine leakage occurs from the vagina. This a serious health issue with upsetting conditions wherein people are unable to manage their day to day activities as they are always in fear of urine leakage.

This also poses risk for health and hygiene, if not treated may get worsened leading to life threatening conditions in some cases.

What can be management options after vesico vaginal fistula repair?

Surgery is the last and most appropriate treatment after proper diagnosis for vesicovaginal fistulas. It is highly important to make postoperative management like

1. Suture line or bandages should be kept dry

2. Maintenance of hygienic and uninfected suture is essential

3. Antibiotics are often recommended  after surgery to prevent bacterial infections 

4. Sexual intercourse should be avoided for some time

What is a vaginal fistula?

Vaginal fistula is an abnormal opening in the vagina, connecting it to another body organ. Examples of some connections made by vaginal fistulas:

Vesicovaginal fistula– Fistula connecting vagina and bladder

Ureterovaginal fistula– Fistula connecting vagina to ureters (tubes carrying kidneys to urinary bladder) Urethrovaginal fistula- Fistula connecting vagina to urethra (tube carrying urine from urinary bladder  outside the body.

Rectovaginal fistula– Fistula connecting vagina to rectum( portion of large intestine)

Colovaginal fistula- Fistula connecting colon large intestine or colon

Enterovaginal fistula- Fistula connecting vagina to small intestine

What are complications of vaginal fistulas?

1. Recurrence of infections related to vaginal and  urinary tract

2. Major hygiene problems

3. Leakage of feces (stool) or gas that through vagina

4. Irritation and inflammation of anal or vaginal skin

5. Infected tissue  with abscess (painful pus)

6.Recurrent fistulas

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