Gynaecology, by video or in person
Obstetric Fistula (VVF and RVF)
The signs, the danger signs that mean hospital now, and how to see a doctor by video from anywhere in Nigeria.
Signs to look for
Obstetric Fistula (VVF and RVF)
- Urine leaking from the vagina all the time, day and night, after childbirth or surgery
- Stool or wind passing through the vagina
- Sore, raw skin on the thighs and around the vagina from constant wetness
- Repeated urine or vaginal infections
- A smell that does not go away however often you wash
An obstetric fistula is a hole between the birth canal and the bladder (vesicovaginal fistula, VVF) or between the birth canal and the back passage (rectovaginal fistula, RVF). It usually follows a long, blocked labour without timely help, when the baby's head presses on the tissues for so long that their blood supply is cut off. Less often it follows a caesarean section, a hysterectomy or another pelvic operation, or an injury. The result is leaking of urine or stool that cannot be controlled. Many women live with it for years in silence, and some are wrongly blamed or left by their families. A fistula is an injury, not a curse or a punishment, and it says nothing about a woman's character. The most important thing to know is that most fistulas can be repaired with surgery, including ones that have been there for a long time.
Medically reviewed by Dr Debo Odulana, Founder and Chief Executive, Mezo. Last reviewed . This page is general information, not a diagnosis. Care is decided with you after an examination.
Symptoms
- Urine leaking from the vagina all the time, day and night, after childbirth or surgery
- Stool or wind passing through the vagina
- Sore, raw skin on the thighs and around the vagina from constant wetness
- Repeated urine or vaginal infections
- A smell that does not go away however often you wash
- Some women also have weakness in a foot after the labour, from pressure on a nerve
When to See a Doctor
Go to a hospital now if you have a fever with pain in the lower tummy or back, you cannot pass urine at all, or you are bleeding heavily after childbirth or surgery. See a gynaecologist as soon as you can for any leaking of urine or stool from the vagina after a birth or an operation. In the first weeks after the injury, a catheter in the bladder can sometimes let a small fistula close by itself, so early help matters. A first conversation by video is private and can be the start: the gynaecologist listens, explains what can be done, and arranges an examination with a surgeon who repairs fistulas.
Treatment options
- A catheter in the bladder for some weeks, which can close a small, fresh fistula without an operation
- Treating infection, sore skin and anaemia, and improving nutrition before surgery
- Surgical repair, usually through the vagina, by a surgeon experienced in fistula work
- A catheter for about two weeks after the repair while the bladder heals
- Pelvic floor exercises and support afterwards, including for any leaking that remains
- A planned caesarean section for a future birth, to protect the repair
What it costs on Mezo
Starting cash prices for the treatments used for this condition.
Common Questions
Can a fistula be repaired after many years?
Yes. Women who have leaked for years can still have a successful repair. Time does not make it impossible, though the surgeon will check the tissues and treat any infection first.
Is this my fault, or a punishment?
No. A fistula is an injury from a labour that lasted too long without help in time. It is not caused by anything you did, and it is not a curse.
Can I have children after a fistula repair?
Many women do. You will usually be advised to wait until the repair has healed fully and to plan a caesarean section for the birth.
Will my husband or family be told?
Not without your agreement. Your consultation and records are private.
Need Help?
A women's health specialist on a video call, who plans the tests and treatment and says when you need to be examined in person.
See a gynaecologist by videoIf any of the danger signs on this page applies, go to the nearest hospital now instead.
Find a verified gynaecology specialist near you.
Gynaecology in Lagos →Gynaecology in Abuja →Gynaecology in Port Harcourt →Gynaecology in Jos →Gynaecology in Ibadan →Sources and further reading
The guidelines and patient information this page is checked against. Care in Nigeria follows the same evidence; what differs is the price and where it is done.
- Obstetric fistula. United Nations Population Fund (UNFPA). Fact sheet.
Links last checked 3 November 2026.
Medical Disclaimer: This information is for educational purposes only and does not replace professional medical advice. Always consult a qualified healthcare provider for diagnosis and treatment.