• Complex lower urinary tract fistulae (Vesicovaginal fistula, urethral fistula)

    Vesicovaginal fistula

    Vesicovaginal fistula (VVF) is one of the most distressing complications in female urology. VVF is an abnormal communication between the bladder and the vagina that results in continuous urine leakage. Birth trauma remains the most common cause of VVF in developing countries. In industrialized nations, however, most fistulas result from complications of gynecologic and other pelvic surgery, such as a hysterectomy. Surgical therapy remains the gold standard of treatment of VVF.

    Urethrovaginal fistula

    Urethrovaginal fistula (UVF) also presents a challenging diagnostic dilemma for the pelvic reconstructive surgeon. UVF is an abnormal communication between the urethra and the vagina that results in continuous urine leakage. Similarly, UVF may result from traumatic obstetric deliveries, pelvic surgical procedures and irradiation for pelvic malignancies. Because of its uncommon occurrence, most UVFs are seen and treated in specialized centers.