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Updated: Aug 29, 2026

Assessing Urinary Tract Junction Obstruction Defects by Methylene Blue Dye Injection
Published on: October 12, 2017
Retrograde vaginal methylene blue injection for localization of complex urinary fistulas
Kamal A Hanash1, Hassan Al Zahrani, Alaa A Mokhtar
1Department of Urology-MBC 83, King Faisal Specialist Hospital & Research Centre, PO Box 3254, Riyadh 11211, Saudi Arabia. khanash@kfshrc.edu.sa
Background:
Ureterovesical and vesicovaginal fistulae usually are easily diagnosed with standard techniques, including radiology, double-dye test, cystoscopy, and vaginal examination. In a few complex cases, however, the localization of the fistulous orifice may be extremely difficult.
Method:
We describe a novel technique of retrograde vaginal methylene blue testing that may assist in the proper localization of the fistulous opening.
Results:
Our experience with one case each of ureterovesical and vesicovaginal fistula easily diagnosed with this method proves its efficacy, simplicity, and safety.
Conclusion:
This technique should be reserved for cases of urinary fistulae when all standard diagnostic methods have failed.
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