Vesico-Vaginal Fistula

Vesico-vaginal fistula (VVF) is a distressing condition where an abnormal passage forms between the bladder and the vagina, leading to continuous leakage of urine. This not only affects a woman's physical health but also her emotional and social well-being. Fortunately, vesico-vaginal fistula repair offers effective solutions for restoring urinary continence and quality of life. This guide covers the causes, symptoms, diagnosis, surgical repair options, and treatment availability globally, including in India.

A vesico-vaginal fistula is a urogenital condition in which there is an abnormal connection between the bladder and the vagina. As a result, urine leaks involuntarily through the vaginal canal. It commonly occurs due to trauma during childbirth or pelvic surgery and can have a significant impact on a woman's dignity and day-to-day functioning.

• Prolonged obstructed labor: Most common in low-resource settings without access to emergency obstetric care.
• Surgical trauma: Especially during hysterectomy or pelvic procedures.
• Radiation therapy: Pelvic radiation may damage tissues leading to fistula formation.
• Cancer: Advanced bladder or cervical cancer may erode into surrounding structures.
• Infections: Severe pelvic infections or tuberculosis can also cause fistulas.

Primary symptom: Constant, painless urinary leakage from the vagina.

• Vaginal irritation and discomfort
• Foul-smelling vaginal discharge
• Recurrent urinary tract infections (UTIs)
• Emotional distress and social isolation

Diagnostic tests include:

• Pelvic examination and dye test
• Cystoscopy to visualize the bladder internally
• MRI or CT scan for complex or multiple fistulas

Surgical intervention is the gold standard for treating VVF. The choice of technique depends on the size, location, complexity, and prior history of repairs.

• Transvaginal Repair: Ideal for simple, low-lying fistulas; offers faster recovery.
• Transabdominal Repair: Preferred for high or complex fistulas; allows better visualization.
• Laparoscopic & Robotic Surgery: Minimally invasive with quicker healing and less scarring.
• Tissue Interposition: Flaps like Martius, omental, or gracilis are used to reinforce repair and promote healing.

• Catheterization for 10–14 days
• Antibiotics to prevent infection
• Estrogen therapy for postmenopausal women
• Follow-up imaging to ensure fistula closure

In Low-Resource Countries: VVF is a major issue in regions like Sub-Saharan Africa and South Asia. Free or subsidized surgeries are offered through NGOs and government initiatives.

In High-Income Countries: Access to robotic surgery, urogynecology specialists, and high-tech diagnostics leads to better outcomes for complex cases.

Many international patients choose countries like India for high-quality, affordable treatment:

• India: Experienced urogynecologists, advanced surgical care, and economical packages.
• Turkey: High success rates with luxury recovery options.
• Thailand and UAE: Known for private, modern facilities and patient comfort.

• Over 85–95% success for first-time, simple fistulas
• Complex and radiation-induced fistulas may need multiple procedures
• Outcomes improve significantly with expert care and early treatment

• Emotional counseling and support groups
• Reintegration programs with vocational training
• Community awareness campaigns to reduce stigma

• Timely cesarean sections in obstructed labor cases
• Training skilled birth attendants
• Ensuring safe gynecologic surgeries with experienced surgeons
• Educating rural communities on maternal care

• Look for board-certified urologists or urogynecologists
• Check for high surgical success rates
• Ensure access to advanced diagnostics and minimally invasive surgery
• Postoperative care and psychological support services
• Transparent pricing and travel support for medical tourists

Vesico-vaginal fistula is a highly treatable yet life-altering condition. Timely diagnosis and surgical repair can help women reclaim their lives with restored dignity and comfort. Whether seeking treatment locally or abroad, specialized care from expert surgeons in countries like India offers hope and healing. At MedPal India, we assist international patients in accessing top urological care with compassion and affordability.