VVF
Presentation
VVF is an abnormal fistulous tract extending between the bladder and the vagina that allows the continuous involuntary discharge of urine into the vaginal vault.
In addition to the medical sequelae from these fistulas, they often have a profound effect on the patient's emotional well-being.

Causes
It is often caused by childbirth (in which case it is known as an obstetric fistula), when a prolonged labor presses the unborn child tightly against the pelvis, cutting off blood flow to the vesicovaginal wall. The affected tissue may necrotize, leaving a hole.

Vaginal fistulas can also result from violent rape. This injury has become common in some war zones, where rape is used as a weapon against civilian populations. As a result, some health centers in countries such as the Democratic Republic of Congo have begun to specialize in the surgical repair of vaginal fistulas.

It can also be associated with hysterectomy, and cone biopsy.
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