A urogenital fistula is an abnormal communication between the urinary tract and the vagina that causes urine to leak into the vagina via a route other than the urethral meatus. Vesicovaginal fistulae represent the most common type of fistula encountered by pelvic surgeons today. In developed countries, the more common etiologies include pelvic surgeries for hysterectomy, incontinence, or pelvic reconstructive procedures. In developing countries, pregnancy-related complications from obstructed labor result in ischemic injury to the bladder and vagina and can lead to very large fistulae that can be difficult to treat.