title: Large vesico-vaginal fistula caused by a foreign body.
abstract: Foreign body is a rare cause of vesico-vaginal fistula most often reported in developed countries. In developing countries obstructed labor is the commonest cause of fistula. A nulliparous 19-year-old female presented with a 3-week history of a foreign body in the vagina causing urinary incontinence and offensive vaginal discharge. Her guardian allegedly inserted the foreign body after she refused a pre-arranged marriage. A plastic container was removed from the vagina under general anesthesia. A large vesico-vaginal fistula was discovered, which was successfully surgically repaired. We recommend urgent removal of the foreign body, preferably under general anesthesia. However, if the history or physical examination reveals prolonged exposure, repair of the fistula should be delayed to allow for adequate debridement in order to prevent any life-threatening complications.
authors.affiliation: Department of Obstetrics and Gynecology, Bugando Medical Centre Box 1370, Mwanza and Catholic University of Health Science and Allied Sciences, Box 1464, Mwanza, Tanzania.
authors.forename: An
authors.initials: A
authors.lastname: Massinde
authors.forename: A
authors.initials: A
authors.lastname: Kihunrwa
keywords: Developing countries; Fistula; Foreign body; Vagina