Fig. 17
From: Multidetector CT of expected findings and complications after hysterectomy
Vesico-vaginal fistula (VVF) developing after radical AH and radiotherapy for endometrial carcinoma in a 66-year-old female, manifesting with vaginal discharge without abnormal findings at gynaecological examination. Excretory-phase CT (A, B) showed a well- opacified urinary bladder with a Foley catheter and left-sided ureteral stent (thin arrow) in place, lateral retraction and opacification of the vagina (arrows) through a short communication (arrowheads) consistent with VVF. After vaginal electrocoagulation, long-term antibiotics and ureteral stenting, repeated CT urography 6 months later (C) showed persistent vaginal opacification (arrow) through the high-output supratrigonal VVF. A year later, CT follow-up (D) showed non-opacified vagina (arrow) indicating fistula closure (Partially reproduced with permission from ref. no. [62])