Introduction: Vesicovaginal Fistula (VVF) is a planetary health care problem in which there is abnormal communication between urinary bladder and vagina leading to true incontinence. It creates health care and social problems for the patients due to distressing symptoms of continuous urinary leakage and recurrent infections of urinary track. VVF has also remained a challenge the Surgeon regarding success of its repair. Objective: This study was performed to determine the change in the etiological trends of VVF, management and success of its management. Materials and Methods: This study was conducted during a period of 5 years from January 2011 to December 2015 in Gynae & ObsB Unit of Ayub Teaching Hospital. A total of 25 patients presented with VVF. Etiology of VVF was determined by retrospectively seeing into history of the patient. After complete evaluation of the patient with detailed history examination and investigations, repair surgery was performed. Outcomes of repair were evaluated over next three months. Results: Out of these 25 cases 12(48%) were due to Obstetrical trauma, 10(40%) cases after obstructed labour2(8%) cases after VBAC with scar dehiscence and bladder damage. 4(16%) cases developed after caesarean section in which 2(8%) cases had placenta percreta involving the bladder. 7(28%) cases occurred iatrogenically after total abdominal hysterectomy for gynae problems. 1(4%) case presented with repeated VVF due to bladder stone. 1( 4%) case ended in failure in which there was a compound fistula involving the bladder and ureter. Conclusions: VVF is common obstetrical complication in our part of the country as in other developing countries. The rate of VVF due to iatrogenic cause is also on a rise as time is passing by, with the increase in surgical treatment of gynaecological problems.

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