Vesicovaginal fistula, or VVF, is an abnormal connection between the bladder and vagina that causes continuous involuntary discharge of urine into the vagina. It is often caused by prolonged and obstructed childbirth but can also result from other conditions like cancer operations or radiation therapy. VVF is typically repaired either through the vagina or laparoscopically, though complex cases may require an open abdominal surgery. While surgery often successfully repairs the fistula, complications can include the fistula recurring or injuries to nearby organs.
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14-1 Vesicovaginal Fistula
Vesicovaginal fistula, or VVF, is an abnormal connection between the bladder and vagina that causes continuous involuntary discharge of urine into the vagina. It is often caused by prolonged and obstructed childbirth but can also result from other conditions like cancer operations or radiation therapy. VVF is typically repaired either through the vagina or laparoscopically, though complex cases may require an open abdominal surgery. While surgery often successfully repairs the fistula, complications can include the fistula recurring or injuries to nearby organs.
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VESICOVAGINAL FISTULA
INTRTODUCTION
Vesicovaginal fistula, or VVF, 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. In addition to the medical sequela from these fistulas, they often have a profound effect on the patient's emotional well-being. CAUSES
It may be the result of a congenital birth condition such as VATER or
VACTERAL. It is often caused by childbirth (in which case it is known as an obstetric fistula), 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 (die), leaving a hole. Vaginal fistulas can also result from particularly violent cases of rape, especially those involving multiple rapists and/or foreign objects. 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, cancer operations, radiation therapy and cone biopsy. TREATMENT
Vesicovaginal fistulae are typically repaired either transvaginally or
laparoscopically, although patients who have had multiple transvaginal procedures sometimes attempt a final repair through a large abdominal incision, or laparotomy. The laparoscopic (minimally invasive) approach to VVF repair has become more prevalent due to its greater visualization, higher success rate, and lower rate of complications. Possible complications of surgical treatment
Recurrent formation of the fistula
Injury to ureter, bowel, or intestines Vaginal shortening