Trans-vaginal sonographic evaluation of vesicovaginal fistula.
OBJECTIVE
To determine the sensitivity of transvaginal ultrasound (TVUS) in the detection of vesicovaginal fistula (VVF).


METHODS
The study included 15 patients with urinary incontinence suspected or diagnosed to be due to vesicovaginal fistula that were originally referred to the department for intravenous urography (IVU). Complimentary TVS was done with consent. Cases with stress incontinence and co-existent rectovaginal fistulae were excluded. Findings were compared against the cystogram, cystoscopy and surgical findings for determining the sensitivity, the last being taken as the gold standard.


RESULTS
The fistula was visualized as a jet of echoes in real time from bladder to the vagina in all 15 cases. The location number and size corresponded with the surgical findings. The sensitivity of trans-vaginal scanning in diagnosing WF was 100%, that of cystoscopy- 93% and of cystography- 60%.


CONCLUSIONS
In this series, the trans-vaginal scan findings correlated well with the surgical findings. It was less invasive and more tolerable than cystoscopy.
Sohail
Saba
S
Department of Radiology, Dow University of Health Sciences and Civil Hospital, Karachi.
Siddiqui
Kausar Jehan
KJ
D000293:Adolescent; D000328:Adult; D003558:Cystoscopy; D005260:Female; D006801:Humans; D012680:Sensitivity and Specificity; D014463:Ultrasonography; D014549:Urinary Incontinence / Q000000981:diagnostic imaging* / Q000209:etiology / Q000601:surgery; D014719:Vesicovaginal Fistula / Q000150:complications / Q000000981:diagnostic imaging* / Q000601:surgery