Vesicovaginal fistulae (VVFs) are uncommon. Urinary loss-in women with VVF occurs immediately after surgical trauma, at 7 to 30 days after hysterectomy or cesarean delivery, and up to 30 years after irradiation. Permanent urinary leakage has a devastating impact on a woman's health, hygiene, psyche, quality of life, and sexuality. Initial management usually includes a trial therapy with bladder drainage. Because spontaneous closure with drainage occurs in only 7% to 15% of patients, most fistulae are managed surgically. Two surgical routes are used: transvaginal and transabdominal. The latter allows for an open, laparoscopic, or robotic procedure. Studies assessing fistula repair usually report anatomical outcomes without examining quality of life or sexual function outcomes. Despite the adverse impact of incontinence on sexual function, few data are available that analyze sexual function before and after fistula repair.
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