Dear Hope,
There are several different conditions that could cause urine to leak from your vagina. One condition is vaginal pooling of urine. This typically occurs in heavier women with a recessed urethra. Urine is expelled from the urethra and then pools in the vagina until the woman stands up. Leakage then occurs. Another condition is vesicovaginal fistula. This is an abnormal communication between the bladder and the vagina. Leakage of urine is directly related to the size and position of the fistula. The amount of urine leaked can vary between a slight position-dependent drainage and total incontinence.
Predisposing risk factors for a vesicovaginal fistula include radiation, C-section, endometriosis, prior pelvic surgery, diabetes, or pelvic inflammatory disease. The fact that you have had both endometriosis and previous pelvic surgery would definitely put you at an increased risk for a fistula. The complete work-up for a vesicovaginal fistula should include a urinalysis, urine culture, and an intravenous pyelogram (IVP). Other tests such as cystoscopy and vaginoscopy may also be needed. If you do indeed have a fistula, surgical repair may be recommended. You would benefit greatly from being seen by a Urologist and explaining your problem to him and undergoing a complete history and physical exam.
This information is provided for general medical educational purposes only. Please consult your physician for diagnostic and treatment options pertaining to your specific medical condition. More individualized care is available at the Henry Ford Hospital and its satellites (1 800 653-6568).
Sincerely,
HFHS M.D.-BL