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Explain this in easy way with mnemonic
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Urogenital Fistulas - The 5 Types
The image shows a sagittal (side-view) cross-section of the female pelvis with 5 abnormal passages (fistulas) marked in yellow/orange lines.
What is a Fistula?
A fistula = an abnormal tunnel between two organs that should NOT be connected. Think of it like a "wrong door" being punched between two rooms.
The 5 Types (numbered in diagram)
| # | Name | Connection | "Wrong door" between... |
|---|---|---|---|
| 1 | Vesicovaginal | Bladder ↔ Vagina | Most common type |
| 2 | Vesicouterine | Bladder ↔ Uterus | |
| 3 | Urethrovaginal | Urethra ↔ Vagina | Lowest, near the opening |
| 4 | Ureterouterine | Ureter ↔ Uterus | High up, near kidney tubes |
| 5 | Ureterovaginal | Ureter ↔ Vagina |
Easy Mnemonic
"Very Very Ugly Uncle Ursula"
| Word | Fistula |
|---|---|
| Very | Vesicovaginal (1) |
| Very | Vesicouterine (2) |
| Ugly | Urethrovaginal (3) |
| Uncle | Ureterouterine (4) |
| Ursula | Ureterovaginal (5) |
Another way to remember - by structure involved:
Two structures create fistulas: BLADDER family vs URETER family
BLADDER side (Vesico- / Urethro-):
Vesico → to Vagina (1) or to Uterus (2)
Urethro → to Vagina only (3)
URETER side (Uretero-):
Uretero → to Uterus (4) or to Vagina (5)
Key Exam Facts
- Most common urogenital fistula = Vesicovaginal (#1) - caused by prolonged obstructed labor or post-hysterectomy injury
- Symptom of all = continuous leaking of urine through the vagina (except vesicouterine which may present as cyclic hematuria - "menouria")
- Vesicouterine fistula = presents with Youssef syndrome: menouria (blood-stained urine during periods) + amenorrhea + urinary continence
Visual Trick for the Diagram
Think of the diagram from bottom to top:
- Bottom (urethra level): #3 Urethrovaginal
- Middle (bladder-vagina junction): #1 Vesicovaginal + #5 Ureterovaginal
- Higher (bladder-uterus level): #2 Vesicouterine
- Highest (ureter-uterus level): #4 Ureterouterine
The fistulas go from low to high = 3 → 1 → 5 → 2 → 4 in the pelvis!
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