Do you also have urine leaking from your vagina without realizing it? Let's talk about Vesicovaginal Fistula (VVF)

Do you sometimes feel like you can't control your body? I understand how embarrassing and embarrassing it can be, especially when you accidentally leak a little urine no matter how hard you try. When your underwear is constantly wet and you feel like you're smelling bad, you don't even want to face society. This is a problem that many women suffer in silence, but are reluctant to talk about. But don't worry, you're not alone. Today we're going to talk about a medical condition that can cause this, namely Vesicovaginal Fistula (VVF).

What exactly is Vesicovaginal Fistula (VVF)?

Simply put, a Vesicovaginal Fistula (VVF) is an abnormal opening or connection between your bladder and vagina . Think about it, normally the urine in our bladder exits the body through the urethra. That's the right way.

But when this VVF condition occurs, it's like a new little "shortcut" is created between the bladder and the vagina. This hole is what we call a fistula. So because of this hole, some of the urine in the bladder doesn't go the right way, but instead starts to leak out through this new shortcut, which is through the vagina, without realizing it. Sometimes this can be a little wetness, or sometimes it can be a constant stream of urine.

Although this is a physical problem, the psychological stress it causes is not insignificant. But the good news is that this condition can often be completely cured with surgery. Your doctor and medical team are always ready to provide you with the treatment and support you need.

What are the common symptoms of this condition?

A person with a VVF can experience a variety of symptoms. These symptoms can vary depending on the size of the hole and other factors. If you are experiencing any of these symptoms, it is important to see a doctor as soon as possible.

What are the causes of VVF?

A VVF occurs when the tissue between the bladder and vagina is damaged and dies. This damage then forms a hole. There are several main reasons for this damage.

• Pelvic Surgery: This is the main cause of VVF in countries like ours. Especially during hysterectomy and bladder surgery, these tissues can be damaged by mistake. This is not the doctor's fault, but a complication that can occur during surgery.
• Obstructed Labor: In a difficult labor that takes a long time to deliver the baby, the baby's head can press hard on the tissue between the bladder and the vagina, cutting off blood flow to that area and causing the tissue to die. This hole can form and urine can start leaking a few days after the baby is born. Although this cause has decreased somewhat in Sri Lanka due to improved medical facilities, the risk is still not completely eliminated.
• Cancer conditions and treatments: Conditions like cervical cancer and bladder cancer can also cause VVF. Also, radiation therapy for cancer can weaken the tissue and cause these types of holes to form over time.

Are there any other complications that could arise from this?

If VVF is not treated properly, other health problems can occur.

• Recurrent infections: Because urine is constantly trapped in the vagina, urinary tract infections (UTIs) and vaginal infections can occur frequently.
• Abscess or Infection: If left untreated, the infection can become severe and form an abscess, which can be life-threatening.
• Recurrence even after treatment: Sometimes, even after surgery, there is a small chance that this fistula will recur.
• Psychological and social problems: Frequent urination and bad breath can make it difficult for you to socialize, attend events, or be with family. This can lead to depression and social isolation.

How does a doctor find this?

When you go to see a doctor, they will first ask you about your symptoms, previous surgeries, and childbirth history. Then they will do a physical exam and pelvic exam. To confirm this and plan the surgery, the doctor will decide to do some special tests.

What are the treatments for this?

The main and most successful treatment is surgery . Surgery is used to close the hole.

A very small, newly formed fistula can sometimes heal on its own without surgery, by keeping a Foley catheter in place for a few weeks and giving the bladder a rest. However, this is very rare.

Many people need surgery. This surgery can be done vaginally or through an incision in the abdomen (through the stomach) . Sometimes, keyhole surgery, such as laparoscopy, may be used. Your surgeon will discuss with you which surgery is best for you.

After surgery, you will need to have a urinary catheter in place for two to three weeks. This is to give the surgical site time to heal without any pressure. After that time, the doctor will remove the catheter after checking to see if the fistula has healed properly.

How long does it take to recover after surgery?

It can take about 6 to 8 weeks to fully recover from a VVF surgery. It is very important to follow your doctor's instructions carefully during this time. Typically, you will be advised to avoid the following during this time:

• Sexual intercourse: You should avoid sexual intercourse until the surgical area has completely healed.
• Weight lifting: Avoid lifting heavy objects and doing strenuous exercise.
• Strenuous activities: It is important to avoid doing anything that makes the body feel tired.

Resting in this way will greatly help the surgical wound heal well and prevent further problems.

In experienced hospitals that perform this type of surgery frequently, 85-95 out of 100 people have a complete cure after the first surgery. This means that urine flow stops completely. Some people may need a second surgery. It depends on factors such as the size of the fistula, its location, and your overall health.