A vesico-vaginal fistula (VVF) following prolonged obstructed labor in a young primipara is most likely located at:

• A Juxtaurethral/bladder neck region ✓
• B Juxtacervical position near the uretero-vesical junction
• C Mid-vaginal position adjacent to the bladder neck
• D Posterior bladder wall at the vault

Explanation

Obstetric VVF from prolonged obstructed labor typically results from pressure necrosis of the bladder neck and urethrovesical junction as the fetal head is impacted against the pubis. The fistula most commonly forms at the bladder neck/juxtaurethral area, often involving the urethra (urethrovaginal fistula component). Iatrogenic VVF from gynecological surgery typically occurs at the posterior bladder wall or near the uretero-vesical junction.

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

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.