The most common cause of vesicovaginal fistula(VVF) in under-developed countries would be:
Causes of vesico vaginal fistula: Gynaecological Surgery: Most common cause in developed countries Obstetric injury/ Obstructed labour (leading to tissue necrosis): Most common cause in developing countries Radiation Malignancy Foreign bodies: forgotten pessaries Direct trauma Infective: TB, schistosomiasis, syphilis, LGV Endometriosis, perforating bladder calculi
Obstetrical injury
Pelvic irradiation
Carcinoma
Haemorrhoidectomy
Genital Prolapse - various presentation of prolapse and management of urinary stress incontinence (I am hanging by my nails !)