Aim :This studyaims to present the anatomical, clinical and lower urinary tract symptom outcomes of women with VVF. Materials and methods:In this Study we include the patients with VVF. Data regarding pre-operative evaluation, surgical treatment, and post-operative follow-ups were collected. Surgical approach depended on the cause, type, number, size, location, and time of onset of the fistula. Post-operatively, foley catheter was maintained for at least 1 week with cystoscopy performed prior to removal. Follow-up evaluation included cystoscopy, bladder diaryand multi-channel urodynamic study. Results: We evaluate total 20 patients, 1 had spontaneous closure, 10 were repaired vaginally and 9 abdominally. Patients repaired vaginally were significantly noted to have a mean age of 46.3 ± 7.1 years with VVFs located adjacent the supra-trigone area having a mean distance of 1.7 ± 0.5 cm from the ureteric orifice. Its operative time and hospital stay were significantly shorter. In contrast, abdominally repaired patients had mean age of 35.0 ± 8.2 years and VVFs with mean distance of 0.4 ± 0.4 cm from the ureteric orifice. Post-operatively, 2 cases (14.2%, 2/14) of VVF recurrence and de novo urodynamic stress incontinence (USI) (25%, 2/8) were noted after vaginal repair and 3 cases (50%, 3/6) of concurrent ureteric injury and overactive bladder after abdominal repair. Conclusion: The vaginal route had higher incidence of recurrence and less invasiveness, faster recovery period, and no association with post-op overactive bladder made it more preferable than the abdominal approach.