Figure 19a. Cystography in diagnosis of vesicovaginal fistulas. (a) Lateral cystogram of a patient with vaginal leakage shows a fistula that originates at the high posterior aspect of the bladder wall (arrow), a common site of involvement. (b) Cystogram of another patient shows a very large fistula. B = bladder, V = vagina. (c) Correlative surgical photograph shows a gross defect through the vaginal wall (arrow), through which the bladder catheter can be seen (arrowhead).