Retrograde vaginal methylene blue injection for localization of complex urinary fistulas.

BACKGROUND

Ureterovesical and vesicovaginal fistulae usually are easily diagnosed with standard techniques, including radiology, double-dye test, cystoscopy, and vaginal examination. In a few complex cases, however, the localization of the fistulous orifice may be extremely difficult.

METHOD: We describe a novel technique of retrograde vaginal methylene blue testing that may assist in the proper localization of the fistulous opening.

RESULTS

Our experience with one case each of ureterovesical and vesicovaginal fistula easily diagnosed with this method proves its efficacy, simplicity, and safety.

CONCLUSION

This technique should be reserved for cases of urinary fistulae when all standard diagnostic methods have failed.