Post-hysterectomy Vesicovaginal Fistula: A Case Report

In many developing nations, vesicovaginal fistulas (VVF) continue to be a serious cause of concern. It leads to significant morbidity in urology for women. Patients of VVF experience social rejection as a result of constant dribbling, stink, and wetness, which degrades their quality of life. Hence, this report presents the case of a 45-year-old woman who approached the Outpatient Department of Obstetrics and Gynaecology with complaints of leakage of urine and urinary incontinence for three months with a surgical history of total abdominal hysterectomy. On per-speculum examination, leakage of urine was observed, and on per-vaginal speculum, a rent of 1×2 cm was palpable on the anterior wall of the vagina. For diagnostic assessment, cystoscopy and computed tomography urography confirmed the diagnosis of post-hysterectomy VVF. The surgical intervention involved cystotomy for the supratrigonal fistula, which was 1.5×1.5 cm in size, and the repair was performed by O'Connor's procedure. In conclusion, appropriate preoperative diagnosis, investigations, and principles of surgical intervention lead to improved surgical outcomes.