Causes & Risk Factors of Vesicovaginal Fistula (VVF)

Vesicovaginal fistula (VVF) happens when a small opening forms between the bladder and the vagina. This allows urine to leak continuously into the vaginal canal.

Main Causes in the UK

• Surgical complications
  • Most cases happen after gynaecological surgery, especially hysterectomy.
  • Rarely, VVF may occur after surgery for bladder, pelvic, or cancer conditions.
• Radiotherapy
  • Treatment for pelvic cancers (such as cervical or bladder cancer) can sometimes weaken tissues, leading to fistula formation.
• Trauma or injury
  • In rare cases, pelvic injury, difficult childbirth, or severe infection may cause a fistula.

Global Causes

• In many parts of the world, VVF is most often linked to obstructed labour where emergency obstetric care is not available.
• Prolonged pressure during childbirth can cut off blood supply to tissues, leading to fistula formation.

Risk Factors

• Undergoing hysterectomy or complex pelvic surgery
• Previous radiotherapy to the pelvic area
• Chronic pelvic infection or inflammatory conditions
• Traumatic childbirth (more common in low-resource settings)

Key Takeaway

In the UK, VVF is rare — but when it does occur, it is usually linked to surgical complications or pelvic radiotherapy. Globally, prolonged obstructed labour is the leading cause.

🌸 Understanding the causes can help reduce stigma and ensure women get the specialist care they need.