# Post-hysterectomy Vesicovaginal Fistula: A Case Report

## TL;DR

This case report describes a woman who developed a vesicovaginal fistula after a hysterectomy and was successfully treated with surgery.

## Contribution

The paper presents a clinical case and surgical management of post-hysterectomy vesicovaginal fistula using O'Connor's procedure.

## Key findings

- A 45-year-old woman presented with urinary incontinence due to a post-hysterectomy vesicovaginal fistula.
- Cystoscopy and CT urography confirmed the diagnosis of a 1.5×1.5 cm supratrigonal fistula.
- Surgical repair using O'Connor's procedure led to successful resolution of the fistula.

## Abstract

In many developing nations, vesicovaginal fistulas (VVF) continue to be a serious cause of concern. It leads to significant morbidity in urology for women. Patients of VVF experience social rejection as a result of constant dribbling, stink, and wetness, which degrades their quality of life. Hence, this report presents the case of a 45-year-old woman who approached the Outpatient Department of Obstetrics and Gynaecology with complaints of leakage of urine and urinary incontinence for three months with a surgical history of total abdominal hysterectomy. On per-speculum examination, leakage of urine was observed, and on per-vaginal speculum, a rent of 1×2 cm was palpable on the anterior wall of the vagina. For diagnostic assessment, cystoscopy and computed tomography urography confirmed the diagnosis of post-hysterectomy VVF. The surgical intervention involved cystotomy for the supratrigonal fistula, which was 1.5×1.5 cm in size, and the repair was performed by O'Connor's procedure. In conclusion, appropriate preoperative diagnosis, investigations, and principles of surgical intervention lead to improved surgical outcomes.