Related Experiment Video
Updated: Aug 9, 2026
Removal of an Intravesical Gellhorn Pessary and Staged Repair of a Residual Large Vesico-Vaginal Fistula
Published on: April 14, 2026
Minimizing the urological and psychological morbidity of urinary tract fistulae from VBAC
Donna T Gilmour1, T Michael Vallis, Winifred Lee
1Department of Obstetrics and Gynaecology, Dalhousie University, Halifax NS.
Background:
Because of the relative rarity of the condition, there is no consensus for the timing of surgical repair of fistulae following vaginal birth after Caesarean section (VBAC).
Cases:
Three cases of urinary tract fistulae following VBAC are presented. Two patients had an early repair (24-48 hours after delivery), and the third had a repair at four months after delivery. The surgical approach and intraoperative findings for the early and late repairs are described, and the psychological effects of early and late repair are compared. The early repairs were not technically difficult and were associated with less psychological morbidity.
Conclusion:
In the absence of contraindications, early repair of urinary tract fistulae diagnosed within the first few days after VBAC delivery is preferred. If early repair is attempted, perioperative conditions must be optimized; urogynaecologic or urologic expertise and assistance should be considered.
