Clinical and epidemiological characteristics of patients with vesicovaginal fistulas in a high-complexity public referral hospital from southwestern Colombia.

Abstract

Objective: To describe the clinical characteristics of patients diagnosed with vesico-vaginal fistula in a urology service in Cali, Colombia, between 2016 and 2025.

Methods: A retrospective cross-sectional study was conducted using medical records from the Urology service at a high-complexity public referral hospital in Cali, Colombia, between June 2016 and June 2025. Patients with confirmed vesico-vaginal fistula were identified through ICD-10 codes. Sociodemographic, clinical, and treatment data were extracted and analyzed descriptively.

Results: We found 25 patients with vesicovaginal fistula; the median age was 45 years. A history of cervical cancer and prior radiotherapy was present in 32% and 48% of patients, respectively, and 68% had undergone previous pelvic surgery, most commonly hysterectomy (48%). Cystoscopy was the main diagnostic modality (84%), with a mean fistula size of 14.6 mm and predominantly retrotrigonal or trigonal locations. Conservative management was unsuccessful in all cases, while surgical repair-mostly laparoscopic-achieved a success rate of 72.2%, with postoperative complications occurring in 16.7% of patients.

Conclusion: Vesicovaginal fistula in this cohort was mainly associated with prior pelvic surgery and radiotherapy. Conservative management was ineffective, while surgical repair-especially laparoscopic-achieved acceptable success with low complication rates.