Skip to main content

Advertisement

SpringerLink
Log in

Vesicovaginal fistula

  • Published:
Current Urology Reports Aims and scope Submit manuscript

Abstract

The most common cause of vesicovaginal fistula (VVF) in North America is injury to the bladder during a hysterectomy. In underdeveloped countries, childbirth is the leading etiology of these fistulae. Although the diagnosis of a VVF usually can be readily made in an outpatient setting, care must be exercised not to overlook a second fistula or concomitant ureteral injury. The timing of repair of the VVF is dependent on its etiology, comorbidities, and the anticipated approach for repair of the fistula. The transvaginal approach is more amenable to an early repair, is less invasive, and is accompanied by a 90% or higher success rate. Fistulae related to pelvic irradiation and recurrent fistulae are complex and may require interposition of vascularized tissue for successful repair.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References and Recommended Reading

  1. Dupont MC, Raz S: Vaginal approach to vesicovaginal fistula repair. Urology 1996, 48:7–9.

    Article  PubMed  CAS  Google Scholar 

  2. Wang Y, Hadley HR: Nondelayed transvaginal repair of high lying vesicovaginal fistula. J Urol 1990, 144:34–36.

    PubMed  CAS  Google Scholar 

  3. Stothers L, Shopra A, Raz S: Vesicovaginal fistula. In Female Urology. Edited by Raz S. Philadelphia: WB Saunders; 1996:490–506.

    Google Scholar 

  4. Blandy JP, Badenoch DF, Fowler CG, et al.: Early repair of iatrogenic injury to the ureter or bladder after gynecological surgery. J Urol 1991, 146:761–765.

    PubMed  CAS  Google Scholar 

  5. Arrowsmith SD: Genitourinary reconstruction in obstetric fistulas. J Urol 1994, 152:403–406.

    PubMed  CAS  Google Scholar 

  6. Villasanta U: Complications of radiotherapy for carcinoma of the uterine cervix. Am J Obstet Gynecol 1972, 114:717–726.

    PubMed  CAS  Google Scholar 

  7. Goldstein I, Wise GJ, Tancer ML: A vesicovaginal fistula and intravesical foreign body. A rare case of the neglected pessary. Am J Obstet Gynecol 1990, 163:589–591.

    PubMed  CAS  Google Scholar 

  8. Brown MR, Middleton RG: Vesicovaginal fistula associated with vaginal foreign body. Paper presented at the 73rd Annual Meeting of the Western Section American Urological Association. Salt Lake City, UT. September 14–18, 1997.

  9. Grody MHT, Nyirjesy P, Chatwani A: Intravesical foreign body and vesicovaginal fistula: a rare complication of a neglected pessary. Int Urogynecol J Pelvic Floor Dysfunct 1999, 10:407–408.

    Article  PubMed  CAS  Google Scholar 

  10. Hadley HR, Myers RC: Complications of vaginal surgery: does unintentional cystostomy result in vesicovaginal fistula? Paper presented at the 65th Annual Meeting of the Western Section American Urological Association. Scottsdale, AZ. September 1989.

  11. Davits RJ, Miranda SI: Conservative treatment of vesicovaginal fistulas by bladder drainage alone. Br J Urol 1991, 68:155–156.

    PubMed  CAS  Google Scholar 

  12. Badenoch DF, Tiptaft RC, Thakar DR, et al.: Early repair of accidental injury to the ureter or bladder following gynaecological surgery. Br J Urol 1987, 59:516–518.

    Article  PubMed  CAS  Google Scholar 

  13. Persky L, Herman G, Guerrier K: Nondelay in vesicovaginal fistula repair. Urology 1979, 13:273–279.

    Article  PubMed  CAS  Google Scholar 

  14. Zimmern PE, Hadley HR, Staskin DR, Raz S: Genitourinary fistulae: vaginal approach for repair of vesicovaginal fistulae. Urol Clin North Am 1985, 12:361–367.

    PubMed  CAS  Google Scholar 

  15. Nesrallah LJ, Srougi M, Gittes RF: The O’Conor technique: the gold standard for supratrigonal vesicovaginal fistula repair. J Urol 161:566–568. This article and the editorial comment that accompanies it reflect the wide disparity that exists in opinions on the appropriate operative approach to the management of VVF. Proponents of the transabdominal and transvaginal techniques articulate their preferences with fervor in this article.

  16. Carr LK, Webster GD: Abdominal repair of vesicovaginal fistula. Urology 1996, 48:10–11.

    Article  PubMed  CAS  Google Scholar 

  17. Raz S, Bregg KJ, Nitti VW, Sussman E: Transvaginal repair of vesicovaginal fistula using a peritoneal flap. J Urol 1993, 150:56–59.

    PubMed  CAS  Google Scholar 

  18. Okamura K, Kanai S, Kurokawa T, Kondo A: Endoscopic transvesico-transurethral approach for repair of vesicovaginal fistula: initial case report. J Endourol 1997, 11:203–205.

    PubMed  CAS  Google Scholar 

  19. Nabi G, Hemal AK: Laparoscopic repair of vesicovaginal fistula and right nephrectomy for nonfunctioning kidney in a single session. J Endourol 2001, 15:801–803.

    Article  PubMed  CAS  Google Scholar 

  20. Morita T, Tokue A: Successful endoscopic closure of radiation induced vesicovaginal fistula with fibrin glue and bovine collagen. J Urol 1999, 162:1689.

    Article  PubMed  CAS  Google Scholar 

  21. Evans DH, Madjar S, Politano VA, et al.: Interposition flaps in transabdominal vesicovaginal fistula repairs: are they really necessary? Urology 2001, 57:670–674. The minimal morbidity and higher success rate associated with the use of interpositional flaps justifies the routine use of these flaps, even in the repair of a simple VVF.

    Article  PubMed  CAS  Google Scholar 

  22. Viennas LK, Alonso AM, Salama V: Repair of radiationinduced vesicovaginal fistula with a rectus abdominis myocutaneous flap. Plast Reconstr Surg 1995, 96:1435–1437.

    Article  PubMed  CAS  Google Scholar 

  23. Hsu TH, Rackley RR, Abdelmalak JB, et al.: Novel technique for combined repair of postirradiation vesicovaginal fistula and augmentation ileocystoplasty. Urology 2002, 59:597–559.

    Article  PubMed  Google Scholar 

  24. Raz S: Female Urology. Philadelphia: WB Saunders; 1996.

    Google Scholar 

  25. O’Donnell PD: Urinary Incontinence. St. Louis: Mosby-Year Book; 1997.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Division of Urology, Loma Linda University, 11234 Anderson Street, Room A560, 92354, Loma Linda, CA, USA

    H. Roger Hadley MD

Authors
  1. H. Roger Hadley MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Hadley, H.R. Vesicovaginal fistula. Curr Urol Rep 3, 401–407 (2002). https://doi.org/10.1007/s11934-002-0085-5

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11934-002-0085-5

Keywords

Search

Navigation