Vesicovaginal fistula (VVF) post-hysterectomy is MOST commonly located at which anatomical level?

• A Trigone of bladder (near ureteral orifices)
• B Bladder dome
• C Posterior bladder wall (supratrigonal level) near the vaginal vault ✓
• D Urethovesical junction

Explanation

Post-hysterectomy vesicovaginal fistulas occur most commonly at the posterior bladder wall at the supratrigonal level, adjacent to the vaginal vault where the bladder was dissected during surgery. Obstetric VVF (due to prolonged obstructed labour in low-income settings) is more commonly juxtacervical/trigonal. Post-surgical VVF typically presents 10–14 days postoperatively with painless continuous urinary leakage per vaginum.

Reference: Shaw's Textbook of Gynaecology, 17th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.