2025 Volume 21 Issue 1 Pages 73-77
Vesicovaginal Fistula (VVF) as a Complication of Vacuum-Assisted Delivery: A case of Vesicovaginal fistula (VVF) as a complication of vaginal delivery is extremely rare. We report a case of a 22-year-old woman, gravida 2 para 2, who developed VVF after vacuum extraction and Kristeller’s maneuver. She got pregnant naturally and spent uneventful pregnancy course. By using vacuum extraction (soft cup, 3 times vacuum and Kristeller’s maneuver) due to weak and prolonged labor, she delivered female baby weighing 2053g, with Apgar score 8/10. Extensive cervical lacerations and vaginal mucosal contusions were found. After suturing the lacerations, hematuria and urinary leakage into the vagina led to diagnosis of VVF. Though a Forley catheter was placed for five days, symptoms persisted. On the postpartum 10th day, she was referred to the department of Urology in our hospital. A large fistula was found in the anterior vaginal wall. On the postpartum 46th day, she underwent abdominal VVF closure and urinary tract reconstruction. However, urinary leakage recurred on postoperative 84th day, and a small fistula was detected. Four months later, transvaginal VVF closure was performed, but recurrence was noted again. Due to refractory VVF, she was transferred to a specialized center, and transvaginal VVF repair by using a Martius flap was performed. The bladder catheter was removed one month postoperatively, and after one year, no recurrence was observed.
