A vesico-vaginal fistula (VVF) develops 10 days after an abdominal hysterectomy. The most common site of iatrogenic VVF following hysterectomy is:

• A Trigone, near ureteric orifices
• B Posterosuperior bladder wall at the vault (supra-trigonal) ✓
• C Bladder neck
• D Posterior wall of urethra

Explanation

Iatrogenic VVF following hysterectomy most commonly occurs at the posterosuperior bladder wall (supra-trigonal region) corresponding to the vault of the vagina, where the bladder is dissected off the cervix and upper vagina. This is the area most vulnerable to inadvertent entry or devascularisation during difficult hysterectomies (particularly with adhesions or endometriosis). Obstetric fistulas in contrast typically involve the vesico-cervical or trigonal region due to prolonged obstructed labour pressure necrosis.

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

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.