Vesicovaginal fistula

Case contributed by Ian Bickle
Diagnosis certain

Presentation

Recent nephroureterectomy. Prior pelvic surgery. Catheter is situ post op. Check cystogram prior to removal.

Patient Data

Age: 70 years
Gender: Female
Fluoroscopy

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.

Case Discussion

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.

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