Published 2022-01-11
Muhammad Ilhamul Karim Tjahjodjati


Objective: This study was conducted to find out the frequency and characteristics of urovaginal fistula patients. Material & Methods: This study design used a retrospective descriptive research design conducted at a tertiary hospital in West Java, Indonesia (Hasan Sadikin General Hospital) from 1 January 2010 to 31 December 2016. Results: Of all 22 urovaginal fistula patients, the majority in the age range of 41-50 years, and there was one patient in the age range of 61-70 years. Fourteen patients (63.6%) had defects in the bladder, and 36.5% of patients had defects in the ureters. There were nine patients (40.9%) who had urovaginal fistula after undergoing a hysterectomy procedure. The other causes were cervical carcinoma (40.9%), difficult labor (9.1%), radiotherapy (4.5%), carcinoma rectum (4.5%), cesarean section procedure (9.1%), and other gynecological procedures such as myomectomy or cystectomy (9.1%). Based on the type and location of the fistula, the majority of patients had vesicovaginal fistula/VVF (59%), ureterovaginal fistula/UVF (36%), and a combination of ureterovesicovaginal fistula (5%). The causes of VVF and UVF are different from each other. In patients with VVF, the most common cause is cervical carcinoma (35.7%). Meanwhile, the most common cause of UVF is hysterectomy (75%). Conclusion: Of the various types of urovaginal fistulas, vesicovaginal fistulas are the most frequently encountered. In general, the characteristics of urovaginal fistula patients in Hasan Sadikin General Hospital is slightly different from the literature, especially the cause of fistula. At Hasan Sadikin General Hospital, vesicovaginal fistulas are mostly caused by cervical cancer, not a hysterectomy. For ureterovaginal etiology, the characteristics of patients in Hasan Sadikin General Hospital are caused mainly by hysterectomy.



Urovaginal fistula, vesicovaginal fistula, ureterovaginal fistula, complication


Singh O, Gupta SS, Mathur RK. Urovaginal fistulas in women: a 5-year experience at a single centre. Urol J. 2010; 7(1): 35-9.

De Silva WAS. Vesicovaginal fistula. Sri Lanka Journal of Urology. 2010; 11: 1-6.

Demirci U1, Fall M, Göthe S, Stranne J, Peeker R. Urovaginal fistula formation after gynaecological and obstetric surgical procedures: clinical experiences in a Scandinavian series. Scand J Urol. 2013 Apr; 47(2): 140-4.

Liao CY, Tasi RS, Ding DC. Gynecological surgery caused vesicovaginal fistula managed by Latzko operation. Taiwan J Obstet Gynecol. 2012; 51(3): 359-62.

Mathevet P, Valencia P, Cousin C, Mellier G, Dargent D. Operative injuries during vaginal hysterectomy. Eur J Obstet Gynecol Reprod Biol 2001; 97: 71e5.

Lee RA, Symmonds RE, Williams TJ. Current status of genitourinary fistula. Obstet Gynecol 1988; 72: 313e9.

De Ridder D. An update on surgery for vesicovaginal and urethrovaginal fistulae. Curr Opin Urol. 2011 Jul; 21(4): 297-300.

Patil SB, Guru N, Kundargi VS, Patil BS, Patil N, Ranka K. Posthysterectomy ureteric injuries: Presentation and outcome of management. Urol Ann. 2017 Jan-Mar; 9(1): 4-8.

El-Lamie IK. Urovaginal fistulae: changing trends and personal experience of 46 cases. Int Urogynecol J Pelvic Floor Dysfunct. 2008 Feb; 19(2): 267-72.

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Department of Urology, Faculty of Medicine/Airlangga University