Traumatic Vesicovaginal Fistula following Motor Vehicle Collision

Nicole Brown, Kathryne Holmes and Erika Mabes

^*Correspondance to: Nicole Brown 

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Abstract:

A Vesicovaginal Fistula (VVF) is an abnormal connection between the bladder and vagina and, in developed countries, most frequently arise following gynecologic surgery. A 22-year-old female presented as a level one trauma following a motor vehicle collision. Physical exam revealed lower abdominal seatbelt sign, left hip deformity, and slow active vaginal bleeding. Imaging identified pubic symphysis widening, left hip dislocation, large hepatic laceration, and dependent bladder hyperdensity with a focus of air within the vagina. The patient was taken for exploratory laparotomy. Intraoperative foley catheter placement revealed sanguineous drainage. Digital vaginal exam identified anterior vaginal wall defect, with foley catheter balloon palpable through the defect, confirming VVF. Repair was performed transabdominally with multi-layered closure. VVFs are rare complications of surgical or coital trauma but have not yet been described following blunt traumatic mechanism. High index of suspicion, prompt identification and multidisciplinary management allowed for timely repair and reduced morbidity.

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Cite the Article:

Brown N, Holmes K, Mabes E. Traumatic Vesicovaginal Fistula following Motor Vehicle Collision. Ann Clin Case Rep. 2024; 9: 2696..