A vesicovaginal fistula is an unwanted connection between the bladder and vagina, causing urine to uncontrollably pass through the vagina. This condition can affect daily activities, carrying not only physical discomfort but also emotional and social stigmatization. The causes of this issue often lie in complications following gynecological surgeries, childbirth traumas, consequences of radiation therapy, or the presence of malignant diseases in the pelvic area.

The diagnostic process usually begins with a detailed conversation with the patient, followed by a gynecological examination, and then possibly specialized exams such as cystoscopy, which allows for a detailed inspection of the bladder’s interior, and vaginoscopy, to determine the exact location and nature of the fistula. Sometimes, a dye test is also used to clearly identify the site of leakage.

The choice of treatment method depends on several factors, including the size and position of the fistula, as well as the general condition of the affected tissues. Although in some milder cases a conservative approach (rest, catheter use, and avoiding activities that may lead to worsening) may be attempted, most fistulas require surgical intervention for a permanent solution. Surgical procedures can involve a transvaginal approach, which is often suitable for smaller fistulas, or a transabdominal approach for more complex cases.
The decision on the best surgical approach is made based on a detailed evaluation of the specifics of each individual case and the surgeon’s experience. The postoperative period requires careful monitoring to ensure that the fistula has successfully healed.