Vesicovaginal Fistula (VVF) Treatment in Gomti Nagar Extension, Lucknow – Swastik
Urology Clinic
Swastik Urology Clinic provides specialised evaluation and definitive repair of
vesicovaginal
fistula (VVF) — an abnormal connection between the bladder and vagina
resulting in continuous
urinary leakage. Under the care of Dr. Aditya Sengar (Urologist),
we offer thorough
diagnostic assessment, short-term conservative management where appropriate, and
meticulous surgical repair
using transvaginal, transabdominal or minimally invasive approaches with tissue
interposition to achieve
durable closure and restore quality of life.
What is Vesicovaginal Fistula (VVF)?
A vesicovaginal fistula is a pathological opening between the bladder and vagina
that permits continuous
leakage of urine from the vagina. Patients typically present with painless or
bothersome continuous wetness,
malodour, skin irritation and social distress. Early evaluation and tailored
management are essential for
successful outcomes.
Common Causes of VVF
Obstetric injury from prolonged obstructed labour, iatrogenic injury
during pelvic surgery
(hysterectomy), pelvic radiation, pelvic malignancy, infection or severe
pelvic trauma are the
most frequent causes worldwide. The cause influences tissue quality and
repair strategy.
Clinical Presentation
Continuous leakage of urine per vaginam is the hallmark. Additional
features include perineal
irritation, recurrent urinary infections, vaginal discharge, and
emotional and social impact.
Diagnostic Evaluation
Evaluation includes detailed history and pelvic examination, dye tests
(methylene blue), urine culture,
cystoscopy to localise the fistula, pelvic ultrasound and contrast
studies (cystogram/CT urography)
when necessary. Assessment of fistula size, location, tissue quality and
associated ureteric involvement
guides surgical planning.
Impact on Quality of Life
Continuous urinary leakage causes physical discomfort, skin breakdown,
recurrent infections and significant
psychosocial distress. Definitive repair restores continence, dignity
and social functioning.
Management Principles for Vesicovaginal Fistula
Management is individualised based on fistula aetiology, size, location and
tissue condition:
1. Conservative Management – Small, early fistulas (often
obstetric) may close with continuous bladder drainage using an indwelling or
suprapubic catheter for 4–6 weeks while infection and inflammation are
controlled.
2. Definitive Surgical Repair – Most fistulas require surgery.
Choice of transvaginal vs transabdominal (open, laparoscopic or robotic)
approach depends on fistula position, scar tissue, prior radiation and ureteric
involvement. Multilayered, tension-free closure with robust tissue interposition
is fundamental to success.
3. Tissue Interposition – Use of well-vascularised tissue
(Martius labial fat pad, omental flap, peritoneal flap or gracilis muscle)
between bladder and vagina reduces recurrence, especially in radiated or
recurrent fistulas.
4. Address Associated Problems – Reimplantation of ureters,
management of vaginal stenosis, correction of pelvic organ prolapse and
treatment of infection or malignancy when present.
Surgical Options for VVF Repair
1. Transvaginal Repair
• Preferred for low and mid-vaginal fistulas when tissue planes are
accessible.
• Advantages: shorter hospital stay, less morbidity and direct access to fistula
for multilayer closure.
2. Transabdominal Repair (Open/Laparoscopic/Robotic)
• Indicated for high, complex, recurrent or ureteric-involving fistulas.
• Allows ureteric reimplantation and good interposition (omental)
options.
3. Interposition Flaps
• Martius labial fat pad for primary vaginal repairs.
• Omental or peritoneal flaps for abdominal approach and radiated
fields.
4. Staged & Reconstructive Strategies
• Complex, radiated or recurrent fistulas may require staged procedures, vaginal
reconstruction or urinary diversion in select situations.
Postoperative bladder drainage, infection control and follow-up cystography
prior to catheter removal are standard to ensure healing.
Why Choose Swastik Urology Clinic for VVF Repair?
Swastik Urology Clinic offers compassionate, evidence-based
care for women with fistula:
• Multidisciplinary Expertise
Coordination with gynaecology, plastic/reconstructive and colorectal teams for
complex cases.
• Experience in Vaginal & Abdominal Approaches
Tailored approach using minimally invasive and open techniques with emphasis on
tissue interposition and functional restoration.
• Preoperative Optimisation
Correction of infection, nutritional support and management of comorbidities to
improve healing.
• Postoperative Support & Rehabilitation
Catheter management, wound care, pelvic floor rehabilitation and psychosocial
support.
When to Consider Vesicovaginal Fistula (VVF) Treatment
Vesicovaginal Fistula (VVF) Treatment may be recommended when symptoms persist,
investigations show an important abnormality, or medical management alone is not
giving lasting relief. Early assessment helps identify the cause, judge
severity, and plan the most suitable treatment based on the patient's symptoms,
examination findings, imaging, and overall health.
At Swastik Urology Clinic, Dr. Aditya Sengar offers personalised evaluation for
vesicovaginal fistula (vvf) treatment with a focus on timely diagnosis, safe
treatment planning, and long-term follow-up. This helps patients from Gomti
Nagar Extension, Lucknow and nearby areas receive structured care with better
symptom control and improved quality of life.
Common Reasons to Seek Early Review
- Persistent or worsening symptoms affecting daily life
- Recurrent episodes, infections, pain, bleeding, or blockage
- Abnormal reports on ultrasound, scan, lab tests, or examination
- Poor response to medicines or need for definitive treatment
Follow-Up and Recovery Focus
- Clear diagnosis and treatment planning based on disease severity
- Guidance on medicines, procedure timing, and expected recovery
- Monitoring for symptom relief, healing, and treatment response
- Timely review if there is recurrence, complication, or delayed
improvement
Book Vesicovaginal Fistula (VVF) Treatment Consultation in Lucknow
If you are looking for expert care for
vesicovaginal fistula (vvf)
treatment in Gomti Nagar Extension, Lucknow, Swastik Urology Clinic
provides evaluation, treatment planning, and follow-up tailored to the condition
and the patient's needs. Our aim is to deliver safe, ethical, and
result-oriented urology care with clear counselling at every step.
You can also book your visit through our
appointment page
for consultation and treatment guidance at Swastik Urology Clinic.
Frequently Asked Questions About Vesicovaginal Fistula (VVF) Treatment
When should a VVF be repaired surgically?
Most VVFs require definitive surgical repair after allowing
inflammation to settle and
infection to resolve. Small, fresh obstetric fistulas may be
trialled with catheter drainage
for a few weeks; persistent fistulas or those due to surgery,
radiation or large defects
are best repaired surgically by an experienced team.
What is the success rate of VVF repair?
Success rates for primary transvaginal repair are high (often
>85–95%) in non-radiated,
well-vascularised tissue. Complex, recurrent or radiated
fistulas have lower primary success
and may need staged or adjunctive reconstructive measures.
How long is recovery after VVF repair?
Hospital stay varies with approach; many transvaginal repairs
have short stays (2–5 days).
Continuous bladder drainage is maintained for 10–21 days
depending on repair, and sexual
activity is deferred for 6–12 weeks. Full recovery includes
wound healing, continence and
addressing any associated pelvic issues.
What complications can occur after repair?
Possible complications include recurrence of fistula, urinary
tract infection, bladder or vaginal
scarring, ureteric injury (rare) and wound issues. Use of
healthy interposition flaps and meticulous
technique reduces complications.
