A vesicovaginal fistula (VVF) is an abnormal connection between the bladder and the vagina that results in spontaneous and involuntary leakage of urine via the vagina.

Incidence is poorly reported and is moderately low in the United States, but it is significantly higher in the developing world. The most common cause of VVF in third-world countries is prolonged obstructed labor. In the industrialized world, most cases are due to pelvic / abdominal / urological surgery. Other risk factors include history of pelvic radiation, gynecologic cancers, prior hysterectomy or vaginal surgery, bladder surgery or repair, foreign body erosion (eg, from a pessary), and trauma. Congenital VVF is extremely rare.

Patients will present with complaints of continuous passing of urine via the vagina, increased incontinence, increased leaking of fluid, increased vaginal discharge, or increased urinary tract infections (UTIs) / vaginal infections. A patient may have vulvovaginal irritation from the leakage. There usually will be no pain or other associated symptoms.