Kamla, a 48 years old lady underwent hysterectomy. On the seventh day, she developed fever, burning micturation and continuous urinary dribbling. She can also pass urine voluntarily. The diagnosis is :
Uretero-vaginal fistula Uretero vaginal fistula In case of urinary fistulas, if the patient never needs to void as there is continous dribbling it signifies that the fistula communicates with the bladder. If, there is filling and emptyin of bladd r alon with the fistula it suggests a fistula opening into one ureter i.e. Uretero vaginal fistula.o As far as urethral fistula are concerned, they give little trouble because the urethra is normally empty of urine. However during nucturition urine passes through the fistula and may then fill the vagina to dribble during body movements for a sho time afterwards. Before concluding let's rule out other options as well : In stress incontinence, dribbling of urine occurs only when intrabdominal pressure is raised. In urge continence the patient has urge to void urine at a moment's notice and she is unable to control her bladder and passes urine instantly.
Vesico vaginal fistula
Urge incontinence
Stress incontinence
Uretero-vaginal fistula