Vesico-vaginal fistula with ureteroureterostomy

IVU shows bilateral ureteric stents, right-sided ureteroureterostomy without leak at this site.

Both kidneys concentrate and excrete normally.

CYSTOGRAM shows small volume bladder filled to 150 mL (maximum patient saiety).

Progressive contrast accumulation in a linear fashion with a more bulbous upper end posterior to the bladder in keeping with the vagina.

Bilateral ureteric stents.

Right-sided ureteroureterostomy. 

Small amount of contrast accumulating in the dependent position of the upper vagina. No contrast filled fistulous tract identified.

Bladder filled to 150 mL (maximum patient saiety).

Bilateral ureteric stents.  Right-sided ureteroureterostomy. 

Progressive contrast accumulation in a linear fashion with a more bulbous upper end posterior to the bladder in keeping with the vagina.

Appearances unchanged from prior study. The exact site of the fistulous tract is not identified.

4 mm fistulous from the dome of the bladder to the vaginal vault.

The vagina is filled with a large volume of contrast.

Comment: High vesicovaginal fistula.

The patient felt wet below at the time of the study clinically correlating with the above.

The CT CYSTOGRAM shows the exact site of the tract between the dome of the bladder and the vaginal vault.

It is illustrated with contrast and air within the fistulous tract.

B = bladder.   V = vagina