Vesicovaginal fistula: Difference between revisions

Revision as of 05:41, 16 February 2025

A medical condition involving an abnormal fistulous tract between the bladder and the vagina

Overview

A vesicovaginal fistula is an abnormal fistulous tract that forms between the urinary bladder and the vagina. This condition results in the continuous involuntary discharge of urine into the vaginal vault. It is a significant medical condition that can lead to severe physical and psychological distress for affected individuals.

Causes

The most common cause of vesicovaginal fistula is prolonged obstructed labor, which can lead to tissue necrosis due to pressure from the fetal head. Other causes include surgical trauma, particularly from hysterectomy, pelvic radiation therapy, and pelvic inflammatory disease.

Symptoms

The primary symptom of a vesicovaginal fistula is continuous urinary incontinence, where urine leaks uncontrollably from the vagina. Patients may also experience vaginal discharge, urinary tract infections, and irritation of the vaginal and surrounding skin.

Diagnosis

Diagnosis of a vesicovaginal fistula typically involves a combination of patient history, physical examination, and imaging studies. A dye test, where a colored dye is introduced into the bladder, can help confirm the presence of a fistula if the dye appears in the vagina. Cystoscopy and urography are also useful diagnostic tools.

Treatment

Treatment of vesicovaginal fistula often requires surgical intervention. The surgical approach depends on the size, location, and cause of the fistula. Options include transvaginal or transabdominal repair. In some cases, conservative management with catheterization may be attempted initially.

Prognosis

With appropriate surgical treatment, the prognosis for vesicovaginal fistula is generally good, with high rates of successful closure and resolution of symptoms. However, the condition can recur, and some patients may experience persistent urinary incontinence or other complications.

Prevention

Preventive measures include improving access to quality obstetric care, timely intervention during labor, and careful surgical techniques during pelvic surgeries. Education and training of healthcare providers in the management of labor and surgical procedures can also reduce the incidence of vesicovaginal fistulas.

Related pages

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-'''Vesicovaginal fistula''' (VVF) is a subtype of [[female urogenital fistula]] (UGF), which is an abnormal fistulous tract extending between the [[bladder]] (vesica) and the [[vagina]] that allows the continuous involuntary discharge of urine into the vaginal vault.
+{{Short description|A medical condition involving an abnormal fistulous tract between the bladder and the vagina}}
-==Etiology==
+== Overview ==
-Vesicovaginal fistula is often caused by [[obstetric trauma]], specifically prolonged obstructed labor, but can also be a result of [[radiation therapy]], malignancy, and surgical complications, particularly from procedures such as [[hysterectomy]].
+A '''vesicovaginal fistula''' is an abnormal [[fistula|fistulous]] tract that forms between the [[urinary bladder]] and the [[vagina]]. This condition results in the continuous involuntary discharge of urine into the vaginal vault. It is a significant medical condition that can lead to severe physical and psychological distress for affected individuals.
-==Pathophysiology==
+== Causes ==
-In the case of obstetric fistulas, prolonged obstructed labor causes tissue necrosis due to compression of the soft tissues between the fetal head and the maternal pelvic bone, leading to the formation of a fistula. In the case of iatrogenic fistulas, the fistula is often a result of accidental injury to the bladder or ureters during pelvic surgery.
+The most common cause of vesicovaginal fistula is prolonged [[obstructed labor]], which can lead to tissue necrosis due to pressure from the fetal head. Other causes include surgical trauma, particularly from [[hysterectomy]], [[pelvic radiation therapy]], and [[pelvic inflammatory disease]].
-==Clinical Presentation==
+== Symptoms ==
-Patients with vesicovaginal fistula often present with continuous urinary incontinence, which can lead to social isolation and psychological distress. Other symptoms may include recurrent [[urinary tract infections]], vaginal irritation, and foul-smelling vaginal discharge.
+The primary symptom of a vesicovaginal fistula is continuous urinary incontinence, where urine leaks uncontrollably from the vagina. Patients may also experience [[vaginal discharge]], [[urinary tract infections]], and [[irritation]] of the vaginal and surrounding skin.
-==Diagnosis==
+== Diagnosis ==
-Diagnosis of vesicovaginal fistula often involves a detailed history and physical examination, as well as imaging studies such as [[cystoscopy]] and [[intravenous urography]]. Other diagnostic procedures may include dye tests, where a colored dye is instilled into the bladder and its presence in the vagina is observed.
+Diagnosis of a vesicovaginal fistula typically involves a combination of patient history, physical examination, and imaging studies. A dye test, where a colored dye is introduced into the bladder, can help confirm the presence of a fistula if the dye appears in the vagina. [[Cystoscopy]] and [[urography]] are also useful diagnostic tools.
-==Treatment==
+== Treatment ==
-Treatment of vesicovaginal fistula often involves surgical repair, either through a vaginal or abdominal approach. The choice of surgical approach often depends on the size and location of the fistula, as well as the surgeon's experience and preference. In some cases, conservative management may be attempted, particularly in cases where the fistula is small and the patient is asymptomatic.
+Treatment of vesicovaginal fistula often requires surgical intervention. The surgical approach depends on the size, location, and cause of the fistula. Options include transvaginal or transabdominal repair. In some cases, conservative management with catheterization may be attempted initially.
-==Epidemiology==
+== Prognosis ==
-Vesicovaginal fistula is most common in developing countries, particularly in sub-Saharan Africa and South Asia, where access to emergency obstetric care is limited. However, it can also occur in developed countries, often as a result of surgical complications.
+With appropriate surgical treatment, the prognosis for vesicovaginal fistula is generally good, with high rates of successful closure and resolution of symptoms. However, the condition can recur, and some patients may experience persistent urinary incontinence or other complications.
-==See Also==
+== Prevention ==
+Preventive measures include improving access to quality [[obstetric care]], timely intervention during labor, and careful surgical techniques during pelvic surgeries. Education and training of healthcare providers in the management of labor and surgical procedures can also reduce the incidence of vesicovaginal fistulas.
+== Related pages ==
+* [[Fistula]]
+* [[Urinary incontinence]]
 * [[Obstetric fistula]]
-* [[Ureterovaginal fistula]]
+* [[Pelvic surgery]]
-* [[Rectovaginal fistula]]
+[[File:Vesicovaginal_Fistula.png|thumb|right|Diagram illustrating a vesicovaginal fistula]]
-[[Category:Gynaecology]]
 [[Category:Urology]]
-[[Category:Obstetrics]]
+[[Category:Gynecology]]
-[[Category:Medical conditions]]
+[[Category:Medical conditions related to pregnancy]]
-{{Gynaecology-stub}}
-{{Urology-stub}}
-{{Obstetrics-stub}}
-{{Med-stub}}