Vesico-vaginal fistula

Case contributed by Dr Mostafa Mahmoud El Feky

Presentation

History of hysterectomy, urinary incontinence from vagina.

Patient Data

Age: 40
Gender: Female
CT

CT urography

A wide (8 mm) fistulous tract is noted between the postero-superior angle of the urinary bladder and the vaginal stump vault, with free passage of excreted contrast to fill the vagina.

Case Discussion

Hysterectomy is the commonest predisposing factor for vesico-vaginal fistula. The fistula may be seen as a hypodense area with excretion of contrast into the vagina on delayed CECT images, but is not considered sensitive for detection of vesicovaginal fistulas1. CT cystogram can give the same appearance. Excretory urography may be useful to exclude a concomitant ureterovaginal fistula, which is associated in up to 10% of patients.

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Case information

rID: 53809
Case created: 7th Jun 2017
Last edited: 14th Jun 2017
Inclusion in quiz mode: Included

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