Investigation of Choice for Vesico-Vaginal Fistula is:

Ans. (c) 3 Swab TestRef: Shaws Textbook of Gynecology 16th Ed; Page No-222Vesicovaginal Fistula (VVF)* Most common cause of bladder fistulae (80-90%) in India:Obstetrical problem.# Prolonged labour-- operative--vaginal caesarean section.* Sometime gynaecological cause:# Hysterectomy# Sling operations for stress incontinence* Clinical features: Continuous dribbling of urine--no micturition (true incontinence).* Investigation: Methylene swab test.# The vaginal cavity is packed with three sterile swabs; 50-100mL of dilute methylene blue dye is injected into the bladder through the catheter.# If there is a VVF present, the methylene blue dye stains the uppermost swab.* IVP: Normal in Vesicovaginal Fistula (VVF), but Hydronephrosis on the affected side seen in Ureteric Fistula.