Question
45 yr old female patient underwent hysterectomy, on 7th post op day complaints about continuous dribbling of urine and fever. Micturition was not voluntary, what diagnosis?
| A. |
Vesico vaginal fistula
|
| B. |
Uretero vaginal fistula
|
| C. |
Vesico uterine fistula
|
| D. |
Urethra vaginal fistula
|
Show Answer
|
Correct Answer » A
Explanation
|
|
- Post-hysterectomy complication
- Onset around 7th postoperative day (classic timing for fistula due to tissue necrosis)
- Continuous dribbling of urine
- Loss of voluntary micturition
These findings strongly indicate a communication between bladder and vagina.
A. Vesicovaginal fistula
- Most common urinary fistula after gynecological surgery
- Results from ischemic necrosis of bladder wall
- Leads to:Classical presentation: 5–10 days after surgery
- Continuous urine leakage
- No voluntary voiding possible
Explanation of Other Options
B. Ureterovaginal fistula
- Continuous leakage present
- But normal voluntary urination is preserved (bladder intact)
- Key distinguishing feature
C. Vesicouterine fistula
- Presents with menouria (cyclical hematuria)
- Amenorrhea
- No continuous dribbling
D. Urethrovaginal fistula
- Rare
- Usually due to direct urethral trauma
- Less typical post-hysterectomy
