VVF stands for Vesicovaginal Fistula — a serious medical condition in which there is an abnormal connection (fistula) between the bladder and the vagina. This causes continuous, uncontrollable leakage of urine through the vaginal canal.
Overview
It can be acquired (due to trauma, surgery, childbirth) or less commonly congenital.
VVF is a urogenital fistula, and the most common type of genitourinary fistula.
Continuous urinary incontinence (leaking urine from the vagina, not the urethra)
Vaginal irritation or infection
Foul-smelling discharge
Recurrent urinary tract infections (UTIs)
Skin breakdown or excoriation from constant moisture
Gynecologic surgery complications, especially hysterectomy
Pelvic radiation therapy
Cancer (e.g., cervical cancer invading bladder)
Trauma (e.g., from childbirth, instrumentation, or pelvic fractures)
Prolonged obstructed labor (most common cause)
Leads to ischemia (loss of blood flow), tissue death, and fistula formation
Lack of access to skilled birth care is a major factor
Often reveals urine leaking through the vaginal wall Dye tests (e.g., methylene blue or indigo carmine in bladder)
Visual inspection of bladder to locate fistula
CT urography or MRI to evaluate fistula tract and surrounding tissues
Continuous catheter drainage for 4–6 weeks may allow healing
Timing: Usually delayed for 3–6 months to allow inflammation to resolve, unless it's a fresh injury
Approaches:
Vaginal repair (preferred for low, accessible fistulas)
Abdominal repair (for high or complex fistulas)
May use tissue flaps (e.g., Martius flap) to reinforce repair
Success rates are high in experienced hands
Continuous catheter drainage Antibiotics Prevention of infection and proper wound care
With timely and skilled surgical intervention, >90% of cases can be cured.
Delays in treatment may lead to:
Chronic incontinence
Social isolation
Depression and stigma, especially in resource-limited settings
Social stigma
Marital breakdown
Psychological trauma
Holistic care involves physical treatment plus counseling, community reintegration, and sometimes reconstructive surgery.
Laparoscopic VVF Repair refers to a minimally invasive surgical procedure used to repair a vesicovaginal fistula (VVF) — an abnormal connection between the bladder and the vagina that causes continuous leakage of urine through the vagina.
General anaesthesia is administered.
3–4 small incisions are made in the lower abdomen.
A laparoscope (camera) and instruments are inserted.
Identifies the fistula tract
Carefully dissects and separates the bladder from the vagina
Closes the fistula from both the bladder and vaginal sides (usually in layers)
Sometimes places a tissue flap (e.g., omental flap) between the bladder and vagina to prevent recurrence
A urinary catheter is placed for 10–14 days to allow healing.
Less pain
Minimal blood loss
Shorter hospital stay
Quicker return to normal activities
Comparable success rate to open surgery (typically 85–95%)
Transvaginal repair – often used for small, low-lying fistulas
Open abdominal repair – used for large or complex fistulas
Robotic-assisted repair – for added precision
Hospital stay: 2–3 days
Catheter removal: 1–2 weeks post-op
Return to normal activities: 2–4 weeks
Full healing: 6–8 weeks