Ureterovaginal fistula

Ureterovaginal fistula is a pathological communication between the ureter, the tube that carries urine from the kidneys to the bladder, and the vagina. This condition is a type of urinary fistula and is often a complication of surgical procedures involving the pelvic region, such as hysterectomy or cesarean section.

Etiology

The most common cause of ureterovaginal fistula is iatrogenic, meaning it is caused by medical intervention. This can occur as a complication of pelvic surgeries, particularly those involving the uterus or cervix. Other causes can include radiation therapy, pelvic inflammatory disease, and traumatic childbirth.

Symptoms

The primary symptom of a ureterovaginal fistula is urinary incontinence, specifically continuous leakage of urine from the vagina. Other symptoms can include recurrent urinary tract infections, pelvic pain, and abnormal vaginal discharge.

Diagnosis

Diagnosis of a ureterovaginal fistula typically involves a combination of patient history, physical examination, and imaging studies. Cystoscopy and intravenous urography are commonly used imaging techniques. In some cases, a dye test may be used to confirm the diagnosis.

Treatment

Treatment of ureterovaginal fistula typically involves surgery to repair the fistula. The specific surgical approach depends on the location and size of the fistula, as well as the patient's overall health and personal preferences. In some cases, a nephrostomy may be performed to divert urine away from the fistula and allow it to heal.

Prognosis

With appropriate treatment, the prognosis for ureterovaginal fistula is generally good. However, the condition can significantly impact a woman's quality of life, particularly if it leads to chronic urinary incontinence.