Vesicovaginal fistula: A narrative review

Vesicovaginal Fistula (VVF) is an abnormal connection between the bladder and vagina that results in persistent urinary leakage and significant physical, psychological, and social suffering. In high-resource environments, VVF is primarily iatrogenic, frequently occurring after pelvic surgeries such as hysterectomy, whereas in low-resource areas, it is mainly caused by prolonged obstructed labour, indicating insufficient obstetric care. Diagnosis depends on pelvic examination, dye tests, cystoscopy, and suitable imaging modalities. Small, recent fistulae may resolve with conservative catheter drainage; however, the majority necessitate surgical intervention, which can be performed through transvaginal, transabdominal, or laparoscopic approaches. or robotic methods. A multilayered, tension-free closure with optional tissue interposition is necessary for successful repair. Improved intrapartum care, expert surgical technique, and prompt management of obstructed labour are all part of prevention, which is still crucial. Improving individualised risk assessment, improving minimally invasive repairs, and addressing global disparities that sustain the burden of obstetric fistula are future priorities.