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Vesicovaginal fistula, or VVF, is an abnormal fistulous tract extending between the bladder and the vagina that allows the continuous involuntary discharge of urine into the vaginal vault. [citation needed] In addition to the medical sequela from these fistulas, they often have a profound effect on the patient's emotional well-being.
Abnormal passageways or fistulas can exist between the vagina and bladder, ureters, uterus, and rectum with the resulting passage of urine from the vagina, or intestinal gas and feces into the vagina, in the case of a vaginal–rectal fistula. [1] These vaginal fistulas are named according to the origin of the defect: vesicovaginal; urethrovaginal
Obstetric fistula is a medical condition in which a hole develops in the birth canal as a result of childbirth. [1] [2] This can be between the vagina and rectum, ureter, or bladder. [1] [4] It can result in incontinence of urine or feces. [1] Complications may include depression, infertility, and social isolation. [1]
An abnormal communication (i.e. hole or tube) between the bladder and the uterus is called a vesicouterine fistula, while if it is between the bladder and the vagina it is known as a vesicovaginal fistula, and if between the urethra and the vagina: a urethrovaginal fistula.
Surgery can be carried out through the vagina, bladder or peritoneum and can be done via laparoscopic or robotic surgery. [8] Watchful waiting is the treatment of choice in case of small fistulas. The bladder is catheterised for a period of 4 to 8 weeks in order to allow spontaneous closure of the vesicouterine fistula.
It is important to be alert for leakage around the catheter, which may spill back into the vagina creating the false impression of a fistula. It is also important to ensure that adequate distension of the bladder occurs as some fistulae do not leak at small volumes; conversely, some fistulae with an oblique track through the bladder wall may ...
Vesicovaginal fistulas occur when the woman's bladder, cervix, and vagina become trapped between the fetal skull and the woman's pelvis, cutting off blood flow and leading to tissue death. The necrotic tissue later sloughs off, leaving a hole. Following this injury, as urine forms, it leaks from the vagina, leading to a form of incontinence ...
These types of vaginal fistulas include, most commonly, vesicovaginal fistula and, more rarely, ureterovaginal fistula. These may be difficult to diagnose. The use of standard techniques along with a vaginogram or radiologically viewing the vaginal vault with instillation of contrast media. [29] Nocturnal enuresis is episodic UI while asleep ...