Vesico-vaginal fistula

Case contributed by Rafael Lourenço do Carmo
Diagnosis almost certain


CT for lung cancer staging. No urogenital symptoms. No history of abdominal surgery. Nine previous vaginal deliveries without complications.

Patient Data

Age: 80 years
Gender: Female

Renal excretory phase shows excretion of contrast into the vagina, without identification of fistulous track. Urinary bladder demonstrating two diverticula on lateral walls. No ureteral abnormalities.

Additional findings include right Bosniak I renal cysts, aorto-iliac atheromatosis, degenerative vertebral disease and colonic diverticular disease.

Case Discussion

Vesico-vaginal fistula usually occurs as a complication of childbirth or gynecologic procedure, namely hysterectomy.

Another risk factors include trauma, radiotherapy, pelvic inflammatory disease, diabetes and neoplasms of the bladder and cervix 1.

Our pacient had no history of gynecologic procedures, but had nine previous vaginal deliveries. She was also insulin dependent diabetic, with several microvascular complications.

Delayed contrast-enhanced CT shows excretion of intravenous contrast into the vagina in about 60% of the cases. Air or fluid in the vagina may also be present 2. The fistulous track may or may not be visible.

How to use cases

You can use Radiopaedia cases in a variety of ways to help you learn and teach.

Creating your own cases is easy.

Updating… Please wait.

 Unable to process the form. Check for errors and try again.

 Thank you for updating your details.