Presentation
Hysterectomy 2 years prior, now has continuous dribbling of urine through vagina.
Patient Data
Intravenous urogram for a patient with continuous vaginal leak of urine shows a contrast opacified tubular structure superimposed on the urinary bladder shadow, suggestive of a fistula. Incidentally, a calyceal diverticulum is also seen in right kidney.
Post IVU CT scan of pelvis shows a wide fistulous communication between the posterior wall of urinary bladder and anterior wall of vagina, with contrast in the vaginal cavity.
Case Discussion
A vesico-vaginal fistula is an abnormal fistulous communication between the urinary bladder and vagina. It is seen mostly as a complication of surgeries like hysterectomy or prolonged obstructed labor. In rare cases, a vesico-vaginal fistula may also be seen in cases of pelvic malignancies or radiotherapy patients. The patients present with involuntary and persistent leak of urine through the vagina.
For complete discussion on the condition and its radiographic features please see: vesico-vaginal fistula
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