Vesicovaginal fistula (VVF) is a subtype of female urogenital fistula (UGF). Presentation
Vesicovaginal fistula, or VVF, is an abnormal fistulous tract extending between the bladder (vesica) and the vagina that allows the continuous involuntary discharge of urine into the vaginal vault.In addition to the medical sequela from these fistulas, they often have a profound effect on the patients emotional well-being. Causes
It may be the result of a congenital birth condition such as VACTERL association. It is often caused by childbirth (in which case it is known as an obstetric fistula), when a prolonged labor presses the unborn child tightly against the pelvis, cutting off blood flow to the vesicovaginal wall. The affected tissue may necrotize (die), leaving a hole.Vaginal fistulas can also result from particularly violent cases of rape, especially those involving multiple rapists and/or foreign objects. Some health centers in countries such as the Democratic Republic of Congo have begun to specialize in the surgical repair of vaginal fistulas. It can also be associated with hysterectomy, cancer operations, radiation therapy and cone biopsy. Treatment
Vesicovaginal fistulae are typically repaired either transvaginally or laparoscopically, although patients who have had multiple transvaginal procedures sometimes attempt a final repair through a large abdominal incision, or laparotomy.The laparoscopic (minimally invasive) approach to VVF repair has become more prevalent due to its greater visualization, higher success rate, and lower rate of complications.
It was considered acceptable to operate on them without anesthetic because, Sims claimed, African-American women have a naturally higher pain tolerance.The healing process of the VVF procedure is still arduous. To have a successful recovery from the surgery, it must be successful on the first attempt. Dr. J. Marion Sims operations on African-American enslaved women showcase the dangerous nature of the procedure. There still have not been clear instructions on how to properly recover from the procedure other than taking prescribed antibiotics. See also
Colposcopy
Double dye test
Rectovaginal fistula
Urinary incontinence

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