Vesico-vaginal fistula usually occurs as a complication of childbirth or gynecologic procedure, namely hysterectomy.
Another risk factors include trauma, radiotherapy, pelvic inflammatory disease, diabetes and neoplasms of the bladder and cervix 1.
Our pacient had no history of gynecologic procedures, but had nine previous vaginal deliveries. She was also insulin dependent diabetic, with several microvascular complications.
Delayed contrast-enhanced CT shows excretion of intravenous contrast into the vagina in about 60% of the cases. Air or fluid in the vagina may also be present 2. The fistulous track may or may not be visible.