Vesicovaginal Fistula Compensation

If a vesicovaginal fistula develops following surgery, childbirth, or other medical treatment, or if surgery to correct a vesicovaginal fistula results in a poor outcome, JMW can help you to pursue compensation.

Claims typically arise where a healthcare professional’s actions, or a failure to act, caused avoidable harm. Medical negligence linked to vesicovaginal fistulas can lead to long-term physical effects as well as recognised psychological injury.

At JMW, we help people across England and Wales who have experienced a vesicovaginal fistula as a result of negligent medical care. We have extensive experience handling complex clinical negligence claims involving obstetrics and gynaecology, including cases where surgical treatment or follow-up care fell below an acceptable standard. By combining legal expertise with a sensitive, evidence-led approach, we aim to reduce the strain on you and your family while you pursue a claim.

To speak to a member of the team about vesicovaginal fistula compensation, call 0345 872 6666 or request a call back using the online enquiry form.

To speak to a member of our team today about vesicovaginal fistula compensation, call 0345 872 6666 or or request a call back using the online enquiry form.

Meet the Team

Case Study

This case involves a failure to investigate incontinence following hysterectomy due to vesicovaginal fistula.

What Is a Vesicovaginal Fistula?

A vesicovaginal fistula is an abnormal connection between the urinary bladder and the vagina, and is considered a form of bladder fistula. This unusual opening allows urine to pass directly from the bladder into the vagina, often resulting in continuous urine leakage that cannot be controlled.

Vesicovaginal fistulas are a type of urogenital tract fistula and are considered a serious medical condition due to their impact on physical health, mental health, and overall quality of life. People who live with a vesicovaginal fistula often experience difficulties with hygiene, sleep, intimacy and social interaction, as well as feelings of embarrassment and isolation linked to the stigma associated with urinary incontinence.

In England and Wales vesicovaginal fistulas are rare but most commonly occur as a complication of gynaecological or pelvic surgery, where an injury to the bladder should have been identified and repaired at the time. Obstructed or prolonged labour is also a rare cause, leading to pressure damage and fistula formation

A vesicovaginal fistula can often be diagnosed in an outpatient clinical setting. Healthcare professionals may use imaging or simple diagnostic tests, such as a dye test, to confirm the presence of a fistula and assess its size and location. Where diagnosis is delayed despite clear symptoms, this can worsen outcomes and may be relevant when considering a medical negligence claim.

What Are the Causes of Vesicovaginal Fistula?

A vesicovaginal fistula develops when damage occurs between the urinary bladder and the vagina, creating an abnormal communication that allows urine to leak continuously into the vagina. In the UK, most vesicovaginal fistulas are linked to medical treatment rather than underlying illness.

Common causes include:

• Gynaecological surgery: Procedures such as a hysterectomy or other pelvic or lower abdominal surgery can result in a bladder injury. If this injury is not identified and repaired during surgery, it can later develop into a vesicovaginal fistula as the surrounding tissue breaks down during healing.
• Pelvic surgery involving the urinary tract: surgery carried out close to the urinary bladder increases the risk of fistula formation, particularly if healthy tissue is damaged, blood supply is reduced, or sutures place excessive tension on surrounding tissue.
• Radiation treatment to the pelvis: pelvic radiation therapy can weaken tissue and impair healing, increasing the risk of vesicovaginal fistula formation, sometimes months or years after treatment.
• Obstetric causes following childbirth: although rare in England and Wales, obstetric vesicovaginal fistulas can occur after prolonged or obstructed labour. Sustained pressure during labour can reduce blood flow to pelvic tissues, leading to tissue necrosis and later obstetric fistula formation.
• Infection and poor healing: severe urinary tract infections, delayed wound healing, or breakdown of surgical repairs can contribute to fistula development, particularly where post-operative monitoring is inadequate.
• Complex or repeat surgical procedures: people undergoing multiple pelvic or gynaecological surgeries may face an increased risk of vesicovaginal fistula, especially where scarring or previous damage affects surrounding tissue.

In some cases, vesicovaginal fistulas may occur alongside other vaginal fistulas, such as a ureterovaginal fistula or rectovaginal fistula, which can complicate diagnosis and treatment.

Identifying the underlying cause and risk factors of a vesicovaginal fistula is a central part of assessing whether the condition arose from unavoidable complications or from substandard medical care. This distinction is crucial when considering a vesicovaginal fistula compensation claim.

When Can a Vesicovaginal Fistula Be Caused by Medical Negligence?

Not every vesicovaginal fistula is the result of medical negligence. However, a compensation claim may be possible where the fistula developed because the care you received fell below an acceptable standard and caused avoidable harm.

In England and Wales, vesicovaginal fistula compensation claims most commonly arise where a surgical error should have been identified and addressed at the time, or where symptoms were missed or ignored after treatment.

Medical negligence may be identified in situations such as:

• Missed bladder injury during surgery: during gynaecological or pelvic surgery, including hysterectomy, the urinary bladder may be injured. Where this injury is not recognised and repaired during the operation, it can later develop into a vesicovaginal fistula. In many cases, appropriate checks should have identified the damage before surgery was completed.
• Poor surgical technique or planning: errors in surgical approach, inadequate protection of surrounding tissue, or failure to preserve healthy tissue can increase the risk of fistula formation. This may be particularly relevant in complex or repeat pelvic surgery.
• Delayed diagnosis after surgery or childbirth: the classic sign of a vesicovaginal fistula is continuous urinary leakage. Where these symptoms are reported but not investigated promptly, diagnosis may be delayed, worsening outcomes and increasing the need for more invasive treatment.
• Negligent repair surgery: some people already live with a vesicovaginal fistula following childbirth or earlier treatment and undergo surgery to correct it. If surgical repair is carried out to an inadequate standard and this causes further injury, recurrent fistula formation, or additional trauma, this may form the basis of a claim.
• Failures in obstetric care: although rare in the UK, prolonged or obstructed labour can lead to tissue damage and fistula formation. Where this occurs due to inadequate monitoring, delayed intervention, or failures in obstetric care, medical negligence may be held as the cause.

To succeed in a vesicovaginal fistula compensation claim, it must be shown that the care you received fell below the standard expected of a reasonably competent healthcare professional acting in similar circumstances.

It must also be proven that the negligent care directly caused the vesicovaginal fistula or made its effects worse. This requires a detailed review of medical records and independent expert evidence, which is why early legal advice can be helpful when considering a claim.

What Is the Vesicovaginal Fistula Compensation Claims Process?

Making a vesicovaginal fistula compensation claim involves a structured legal process designed to establish whether medical negligence occurred and whether that negligence caused avoidable harm. JMW will guide you through each stage, explaining what is happening and what to expect, so you are not left feeling uncertain or overwhelmed.

The claims process usually involves:

• Initial assessment: we discuss what has happened, including your symptoms, treatment history, and any surgery or obstetric care you received. This allows us to assess whether a medical negligence claim may be possible.
• Obtaining medical records: we request and review your full medical records, including surgical notes, post-operative care records, and any diagnostic investigations. This helps us understand how and when the vesicovaginal fistula developed.
• Independent expert evidence: we instruct independent medical experts to assess whether the care you received fell below an acceptable standard and whether that failure caused or contributed to the fistula. Expert evidence is a key part of proving medical negligence.
• Establishing causation and impact: we gather evidence to show how the fistula has affected your life, including physical symptoms, psychological injury, and any financial losses you have experienced.
• Pursuing the claim: once the evidence is in place, we pursue the claim on your behalf, keeping you informed as it progresses and advising you on any responses or offers received.

Every case is different, and the length and complexity of the process varies depending on the circumstances, the medical issues involved, and whether liability is disputed. Throughout the claim, we focus on building a clear, evidence-led case while aiming to minimise the strain on you and your family.

If you would like a more detailed overview of how medical negligence claims work, you can read our guide to the medical negligence claims process.

Q

What are common vesicovaginal fistula signs and symptoms?

A

The signs and symptoms of a vesicovaginal fistula vary, but the condition is often immediately life-altering. The most common and recognisable symptom is continuous urinary leakage, which typically begins shortly after pelvic or gynaecological surgery or following childbirth.

Here are some of the most common symptoms that contribute to a vesicovaginal fistula diagnosis:

• Continuous urine leakage through the vagina: unlike stress or urge incontinence, this leakage is constant and not controlled by bladder function.
• Urinary incontinence: ongoing loss of bladder control that does not improve with routine continence treatments.
• Persistent vaginal fluid or discharge: urine passing through the fistula tract into the vagina can cause constant dampness and irritation.
• Recurrent urinary tract infections: the abnormal communication between the bladder and vagina can increase the risk of repeated infections.
• Skin irritation and discomfort: prolonged exposure to urine can cause soreness, inflammation, and damage to surrounding tissue.

Beyond the physical symptoms, vesicovaginal fistulas often have a profound psychological and social impact. Many people experience feelings of embarrassment, shame, and isolation due to the stigma associated with urinary incontinence.

Q

How is vesicovaginal fistula treated?

A

Treatment for a vesicovaginal fistula depends on the size and location of the fistula, how it developed, the condition of the surrounding tissue, and a person’s medical history. Treatment may involve conservative management or surgical intervention, usually led by specialist teams in gynaecology or reconstructive urology.

A treatment plan may include:

• Conservative treatment: small, newly formed vesicovaginal fistulas may sometimes be treated with prolonged bladder drainage using an indwelling catheter, such as a Foley catheter, to support the healing process. In some cases, fibrin glue or similar sealants may be used to help close the fistula tract. This approach is generally limited to uncomplicated fistulas identified early.
• Surgical repair: most vesicovaginal fistulas require surgical treatment, including transvaginal, transabdominal, or laparoscopic vesicovaginal fistula repair, depending on the complexity of the fistula and the condition of healthy tissue. Tissue interposition may be used during vesicovaginal fistula surgery to reduce the risk of recurrent fistula formation.
• Postoperative care: following vesicovaginal fistula surgery, bladder drainage is usually maintained with an indwelling catheter for a period of time to allow healing. Some people may require a catheter for several weeks, particularly after complex repairs.
• Further intervention: even with appropriate treatment, complications can occur, including recurrent fistulas. Some people may need additional surgical intervention or specialist reconstructive urology input if the initial repair is unsuccessful.

Treatment history is an important factor in vesicovaginal fistula compensation claims. When assessing a claim, consideration is given to whether diagnosis was delayed, whether the chosen treatment was appropriate, whether surgery was performed to an acceptable standard, and whether avoidable complications or repeated procedures were required. The physical and psychological impact of treatment, including prolonged recovery or failed repair, is also taken into account when evaluating the overall effect on quality of life.

Q

What evidence will I need to make a claim?

A

To pursue vesicovaginal fistula compensation, it must be shown that the care you received fell below an acceptable standard and that this directly caused the fistula or made its effects worse. Evidence plays a central role in establishing this, and we manage the process of gathering and reviewing key records and documents on your behalf. The evidence required will usually include:

• Medical records: this includes hospital notes, surgical records, obstetric records, post-operative care notes, and follow-up appointments. These documents show what treatment was provided, when symptoms first appeared, and whether appropriate action was taken.
• Diagnostic evidence: records of investigations used to diagnose the vesicovaginal fistula, such as imaging or dye tests, can confirm when the fistula developed and whether diagnosis was delayed.
• Expert medical opinion: we instruct independent medical experts to review your records and provide opinions on whether the care you received met acceptable standards. Experts also assess whether any failures in care caused or contributed to the fistula or its long-term impact.
• Evidence of symptoms and impact: this may include details of continuous urinary leakage, recurrent urinary tract infections, and the effect on your daily life. Psychological injury, including distress linked to stigma, isolation, or loss of dignity, is also relevant and may be supported by clinical evidence.
• Financial records: documents showing loss of earnings, reduced capacity to work, or the cost of care and support can be used to demonstrate financial losses linked to the injury.

You do not need to gather all of this evidence yourself. We will explain what is needed, obtain records on your behalf, and guide you through providing any information that supports your claim. Our role is to build a clear, evidence-led case while making the process as straightforward as possible for you.

Q

What are the time limits for vesicovaginal fistula compensation claims?

A

including claims for vesicovaginal fistula compensation. In most cases, court proceedings must be started within three years.

The three-year period usually runs from:

• The date the negligence occurred, such as the date of the surgery or childbirth that caused the vesicovaginal fistula, or
• The date of knowledge, which is when you first became aware that the fistula may have been caused by substandard medical care. This is particularly relevant where diagnosis was delayed or where symptoms were initially dismissed.

There are important exceptions to these rules:

• Children: if a vesicovaginal fistula was sustained during childhood, the three-year time limit usually begins on the child’s 18th birthday.
• Lack of mental capacity: where a person does not have the mental capacity to manage their own legal affairs, the time limit may not apply unless capacity is later regained.

It is not always obvious when the time limit starts to run, especially in cases involving delayed diagnosis, complex surgical histories, or multiple procedures. For this reason, it is often helpful to seek legal advice as soon as you have concerns about the care you received, even if the treatment took place some time ago.

We can review the circumstances of your case and advise how the limitation period may apply, helping you understand your options without any initial cost or obligation.

Q

How is compensation assessed in vesicovaginal fistula claims?

A

Compensation in vesicovaginal fistula claims reflects the physical, psychological, and financial impact of the injury where it has been caused by medical negligence. The assessment focuses on how the condition has affected day-to-day life, both now and in the future.

Damages are generally broken into two categories:

• General damages recognise the non-financial effects of a vesicovaginal fistula. This includes pain and discomfort, the impact of ongoing symptoms such as urinary incontinence, and the effect on dignity, independence, relationships, and social life. Where there is evidence of lasting psychological injury, such as distress linked to stigma, isolation, or trauma following negligent care, this is also taken into account when assessing compensation.
• Special damages cover financial losses and additional needs arising from the injury. This may include loss of earnings, reduced capacity to work, the cost of care or support, and any treatment-related expenses linked to the fistula or its long-term consequences. Where future care or ongoing support is required, compensation can reflect those needs as well.

Each vesicovaginal fistula compensation claim is assessed on its own facts, based on medical evidence and the individual impact of the injury.

Q

How long will it take to make a vesicovaginal fistula claim?

A

The length of time it takes to resolve a vesicovaginal fistula compensation claim depends on the circumstances of the case and the medical issues involved. Some claims progress more quickly, while others take longer due to the need for detailed investigation and expert evidence.

Factors that can affect how long a claim takes include:

• The complexity of the medical evidence, particularly where surgery, delayed diagnosis, or multiple procedures are involved.
• Whether liability is disputed, as claims may take longer if the healthcare provider does not accept that the care fell below an acceptable standard.
• The severity and long-term impact of the injury, including whether further treatment or surgery is required before the full effects can be assessed.
• The need for independent expert opinions, which are essential in medical negligence claims and can take time to obtain.

Throughout the process, we keep you informed of progress and explain any delays. Where appropriate, we aim to move the claim forward efficiently while making sure the evidence is thorough and accurately reflects how the vesicovaginal fistula has affected your life.