Recent nephroureterectomy. Prior pelvic surgery. Catheter is situ post op. Check cystogram prior to removal.
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Contrast fills the urinary bladder via a catheter, then promptly fills the vagina, via a short fistulous tract at the posterosuperior aspect of the bladder into the upper vagina.
Prior pelvic surgery with adhesions can make for difficulties when returning at a later date for further pelvic surgical intervention.
Malignancy, inflammatory disease and radiotherapy are other potential causes of a vesicovaginal fistula.