If you are experiencing constant leakage of urine, you may worry about what’s happening inside your body. A vesicovaginal fistula (VVF) is rare in the UK, but it is a known complication after some pelvic surgeries or radiotherapy.
Getting the right diagnosis is the first step toward treatment and recovery.
The First Clues
Your doctor will begin by asking about your symptoms and medical history. They may look for:
- Constant leakage of urine from the vagina, even when you don’t feel the urge to pass urine.
- Recent surgery, especially hysterectomy or pelvic procedures.
- History of pelvic radiotherapy or difficult childbirth.
- Recurrent urinary tract infections (UTIs) or irritation that doesn’t improve.
These details give important clues that VVF might be the cause.
Physical Examination
Your doctor may carry out a gentle examination to:
- Check for signs of urine leakage into the vagina.
- Look for irritation, inflammation, or pooling of fluid.
- Rule out other causes of incontinence, such as prolapse or bladder weakness.
Diagnostic Tests
If VVF is suspected, you may be referred to a urogynaecologist or urologist for specialist tests. Common investigations include:
- Dye test – a coloured dye is placed in the bladder; if it appears in the vagina, it confirms a fistula.
- Cystoscopy – a small camera looks inside the bladder to find the opening.
- Imaging tests – ultrasound, CT, or MRI scans can show the size and location of the fistula.
What the Doctor Wants to Know
When diagnosing VVF, doctors are checking:
- Is there a fistula? (Confirming it’s not another type of incontinence)
- Where is it located? (Bladder wall, near the urethra, etc.)
- How big is it? (This helps plan the right repair technique)
- What caused it? (Surgery, radiotherapy, childbirth, trauma)
- Are there other complications? (Infections, scarring, or tissue damage)
Why Diagnosis Matters
A clear diagnosis means you can be referred to a specialist centre for treatment. Repair surgery has a high success rate, especially when the fistula is identified and treated promptly.
Key Takeaway
Your doctor will look for constant leakage, medical history, and physical signs of VVF. Specialist tests like a dye test or cystoscopy confirm the diagnosis. This careful process ensures you get the right treatment and support.
At VVF Support UK, we’re here to help you understand the process and know that you are not alone.
