A vesicovaginal fistula (VVF) is an abnormal connection between the bladder and vagina. This condition causes urine to pass through the vagina, resulting in women experiencing increased discharge and incontinence. There are a variety of risks for a VVF during childbirth, pelvic related medical procedures or radiation therapy, but it can be treated through surgery.
A VVF results from a lack of blood supply to tissues in the vagina and the bladder. Holes start to form between the vaginal wall and bladder, allowing urine to leak through and enter the vagina. Urinal incontinence begins to occur, as well as an increased risk for urinary tract infections and irritation of the vulva. A VVF is a common form of a urogenital fistula (UGF), an umbrella term for unnatural connections between two female organs.
One of the causes of a vesicovaginal fistula is accidental injury to the urinary tract during surgery in the pelvic area, such as a hysterectomy. Damage to tissue in the area near the bladder and vagina from radiation therapy is another factor that could cause this condition. A cut made in the anterial wall of the vagina during female genital mutilation, which is practiced in some countries, can also cause a VVF. This condition occurs if the cut is too deep and starts to create a hole between the vagina and bladder.
Obstructed labor during pregnancy is another common cause of a vesicovaginal fistula in some countries. The complication results in obstetric fistula, which occurs when there is a restriction of blood flow to tissues in the birth canal. These tissues become severely damaged, which causes the woman to experience urinal incontinence.
Obstructed labors also put women at risk for developing a rectovaginal fistula (RVF), a formation of holes between the rectum and vaginal tissues. These holes allow stool to pass through and into the vagina. This complication can cause feces to leak from the vagina uncontrollably.
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. A VVF is diagnosed by conducting a double dye test that includes an oral anesthetic and methylene blue dye. Doctors use a catheter to inject the dye into the bladder or vagina. X-rays are taken during this process to determine whether this dye goes into the vagina.
A vesicovaginal fistula is often treated with surgical procedures that repair holes in the vaginal tissue. Patients might have to use a Foley catheter for as long as 14 days following treatment. Doctors also suggest that intercourse must be avoided for a minimum of six weeks to allow the healing process to complete.