Vesicovaginal fistula

Case contributed by Luu Hanh
Diagnosis certain

Presentation

Hysterectomy 2 months ago. Discharge of urine through the vagina.

Patient Data

Age: 45 years
Gender: Female

CT Pelvis

ct

After a hysterectomy, fat stranding in the pelvis has persisted.

The excretion of contrast from the bladder into the vagina via a fistulous tract is visible on the delayed phase.

Annotated image

Red arrows indicate the fistulous tract between the dome of the bladder and the vaginal vault.

Case Discussion

This case is an excellent illustration of vesicovaginal fistula on delayed CT images. The patient had a previous hysterectomy which is the commonest cause for vesicovaginal fistula.

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