Suspected Bladder-to-Vagina Fistula: What Do the Tests Establish?

If you are trying to describe where urine seems to be leaking from, the appointment can feel awkward before anyone has explained the tests. You can use your own words and ask the clinician to clarify what they are investigating.

Why might an examination not settle it?

A speculum examination can reveal leakage or an opening, but the opening is not always visible. Manchester’s November 2025 leaflet explains that other tests may therefore be needed. A urine sample checks for signs of infection.¹

Ask which question each planned test answers. If an examination worries you, say so before it starts and ask the team to explain what will happen.

What does the blue-dye test show?

The three-swab test uses vaginal gauze swabs and blue dye introduced into the bladder through a catheter. Blue staining shows urine passing from the bladder into the vagina. The stained swab’s position can suggest the location, but the test does not establish the precise site, number or size of openings.¹

This is a clinical procedure. Ask for the service’s preparation instructions rather than trying to reproduce the test at home.

Why might cystoscopy follow?

Cystoscopy with examination under anaesthetic lets the clinician inspect the bladder and vagina, establish the opening’s exact location and size, and check for additional openings. These details help plan treatment.¹

Ask whether this is the procedure being proposed for you, what preparation it requires and when you will hear the results. Write down whom to contact if the instructions are unclear.

What should I bring to the discussion?

Bring your account of the leakage: when you first noticed it, when it happens and what you have already told the team. You do not need to decide the cause before asking for assessment.

Useful questions include: “What has been confirmed so far?” and “What do you still need to find out before discussing treatment?” Ask for a copy of the findings and the next step in writing.

Laugh, Sneeze, Jump includes an appointment prep sheet and a three-day bladder log. You can use them to organize your description and questions for the visit. Follow the clinic’s instructions if it requests a particular record. See the book.