Vesicovaginal fistula (VVF) is "an abnormal communication between the bladder and the vagina which results in the continuous involuntary leakage of urine into the vaginal vault". About 2-3 million women have been reported to have obstetric fistulas worldwide. 1 In Pakistan, about 3500 cases of obstetric fistula occur every year, and about 3% of women of reproductive age experience obstetric fistula signs. 2,3 The most common cause of VVF in low-income countries is prolonged obstructed labor (97%), 4 whereas iatrogenic injury to the urinary tract, mostly from benign gynecologic surgery, is the main cause in the high-income countries. 5 It is estimated that about 0.8/1000 of all hysterectomies are complicated by VVF. 6 Other causes reported