Trans-vaginal sonographic evaluation of vesicovaginal fistula

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Objective: To determine the sensitivity of transvaginal ultrasound (TVUS) in the detection of vesicovaginal fistula (VVF).
Methods: The study included 15 patients with urinary incontinence suspected or diagnosed to be due to vesicovaginal fistula that were originally referred to the department for intravenous urography (IVU). Complimentary TVS was done with consent. Cases with stress incontinence and co-existent rectovaginal fistulae were excluded. Findings were compared against the cystogram, cystoscopy and surgical findings for determining the sensitivity, the last being taken as the gold standard.
Results: The fistula was visualized as a jet of echoes in real time from bladder to the vagina in all 15 cases. The location number and size corresponded with the surgical findings. The sensitivity of trans-vaginal scanning in diagnosing WF was 100%, that of cystoscopy- 93% and of cystography- 60%.
Conclusion: In this series, the trans-vaginal scan findings correlated well with the surgical findings. It was less invasive and more tolerable than cystoscopy.


JPMA. The Journal of the Pakistan Medical Association