Presentation

VVF is an abnormal fistulous tract extending between the bladder

Urinary bladder

The urinary bladder is the organ that collects urine excreted by the kidneys before disposal by urination. A hollow muscular, and distensible organ, the bladder sits on the pelvic floor...

 and the vagina

Vagina

The vagina is a fibromuscular tubular tract leading from the uterus to the exterior of the body in female placental mammals and marsupials, or to the cloaca in female birds, monotremes, and some reptiles. Female insects and other invertebrates also have a vagina, which is the terminal part of the...

 that allows the continuous involuntary discharge of urine

Urine

Urine is a typically sterile liquid by-product of the body that is secreted by the kidneys through a process called urination and excreted through the urethra. Cellular metabolism generates numerous by-products, many rich in nitrogen, that require elimination from the bloodstream...

 into the vaginal vault.

In addition to the medical sequelae from these fistulas, they often have a profound effect on the patient's emotional well-being.

Causes

It is often caused by childbirth (in which case it is known as an obstetric fistula

Obstetric fistula

Obstetric fistula is a severe medical condition in which a fistula develops between either the rectum and vagina or between the bladder and vagina after severe or failed childbirth, when adequate medical care is not available.-Symptoms and signs:The resulting disorders typically include...

), when a prolonged labor presses the unborn child tightly against the pelvis, cutting off blood flow to the vesicovaginal wall. The affected tissue may necrotize

Necrosis

Necrosis is the premature death of cells in living tissue. Necrosis is caused by factors external to the cell or tissue, such as infection, toxins, or trauma. This is in contrast to apoptosis, which is a naturally occurring cause of cellular death...

 (die), leaving a hole.

Vaginal fistulas can also result from violent rape. This injury has become common in some war zones, where rape is used as a weapon against female civilians. As a result, some health centers in countries such as the Democratic Republic of Congo have begun to specialize in the surgical repair of vaginal fistulas.

It can also be associated with hysterectomy

Hysterectomy

A hysterectomy is the surgical removal of the uterus, usually performed by a gynecologist. Hysterectomy may be total or partial...

, and cone biopsy.

See also

• Fistula
  Fistula
  In medicine, a fistula is an abnormal connection or passageway between two epithelium-lined organs or vessels that normally do not connect. It is generally a disease condition, but a fistula may be surgically created for therapeutic reasons.-Locations:Fistulas can develop in various parts of the...
  
  
• Obstetric fistula
  Obstetric fistula
  Obstetric fistula is a severe medical condition in which a fistula develops between either the rectum and vagina or between the bladder and vagina after severe or failed childbirth, when adequate medical care is not available.-Symptoms and signs:The resulting disorders typically include...
  
  
• Rectovaginal fistula
  Rectovaginal fistula
  A rectovaginal fistula is a medical condition where there is a fistula or abnormal connection between the rectum and the vagina. Rectovaginal fistula may be extremely debilitating. If the opening between the rectum and vagina is wide it will allow both flatulence and feces to escape through the...
  
  
• Colposcopy
  Colposcopy
  Colposcopy is a medical diagnostic procedure to examine an illuminated, magnified view of the cervix and the tissues of the vagina and vulva. Many premalignant lesions and malignant lesions in these areas have discernible characteristics which can be detected through the examination...
  
  
• Urinary incontinence
  Urinary incontinence
  Urinary incontinence is any involuntary leakage of urine. It is a common and distressing problem, which may have a profound impact on quality of life. Urinary incontinence almost always results from an underlying treatable medical condition but is under-reported to medical practitioners...
  
  
• Double dye test
  Double dye test
  Double dye test is useful for diagnosing vesicovaginal or ureterovaginal fistulae. For this test, the patient takes oral phenazopyridine 200 mg TDS, and indigo carmine or methylene blue is filled in to the empty urinary bladder via a urethral catheter...
  
  

External links

• Fistula Vesico Vaginal Information in Spanish about Fistula Vesico Vaginal. Caracas, Venezuela
• Worldwide Fistula Fund is a non-profit organization that provides free fistula surgeries and prevention outreach in Danja, Niger
• The International Organization for Women and Development is a non-profit organization that assists in Niger
• One By One - a nonprofit organization working to eliminate obstetric fistula.
• FORWARD - a charity that works to eliminate VVF/fistula and gender-based discriminatory practices such as FGM and child marriage which can cause VVF
• Fistula Foundation - supporting the work of the Hamlin Fistula Hospitals in Ethiopia.
• Women's Health and Education Center
• Urinary Fistula