Abstract
The main cause of vesicovaginal fistula is gynecologic or obstetric manipulation, but vesicovaginal fistula as a complication of genitourinary tuberculosis is extremely rare. The diagnosis is confirmed by the histological findings, and treatment is surgical repair with antituberculous medication. We report here on the presentation and management of extensive tuberculosis that led to formation of a vesicovaginal fistula in an adult.
Figures and Tables
Fig. 1
(A) Excretory urogram reveals a left nonvisualized kidney, right hydronephrosis, hydroureter and a small capacity bladder. (B) Cystogram shows free flow of the contrast material into the vagina and vesicoureteral reflux on the right side.
![kju-47-1025-g001](/upload/SynapseData/ArticleImage/1020kju/kju-47-1025-g001.jpg)
Fig. 2
(A) Cystoscopic view showing a small opening on the medial side of the left ureteric orifice and edematous bladder mucosa. (B) The microscopic findings show that the granulomas are composed of central caseous necrosis surrounded by epithelioid cells and multinucleated giant cells (H&E, ×400).
![kju-47-1025-g002](/upload/SynapseData/ArticleImage/1020kju/kju-47-1025-g002.jpg)
References
1. Lee SS, Kim CI, Lee SJ. Vesicovaginal fistula: 20 years of experience. Korean J Urol. 1991. 32:970–975.
2. Ba-Thike K, Than-Aye , Nan-Oo . Tuberculous vesico-vaginal fistula. Int J Gynaecol Obstet. 1992. 37:127–130.
3. Goel A, Dalela D, Gupta S, Sankhwar SN, Singh KM. Pediatric tuberculous vesicovaginal fistula. J Urol. 2004. 171:389–390.
4. Singh A, Fazal AR, Sinha SK, Ambasta SS, Kulshreshta A. Tuberculous vesicovaginal fistula in a child. Br J Urol. 1988. 62:615.
5. Everett HS, Mattingly RF. Urinary tract injuries resulting from pelvic surgery. Am J Obstet Gynecol. 1956. 71:502–514.
6. Falk HC, Kurman M. Repair of vesicovaginal fistula: report of 140 cases. J Urol. 1963. 89:226–232.
7. Persky L, Herman G, Guerrier K. Nondelay in vesicovaginal fistula repair. Urology. 1979. 13:273–275.
8. Wang Y, Hadley HR. Nondelayed transvaginal repair of high lying vesicovaginal fistula. J Urol. 1990. 144:34–36.
9. Peter C, Leonhard S. Indications for surgical management of genitourinary tuberculosis. World J Surg. 1997. 21:505–510.
10. Gow JG, Barbosa S. Genitourinary tuberculosis. A study 1117 cases over a period of 34 years. Br J Urol. 1984. 56:449–455.