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The urethral fistula symptoms depend on their localization and size. The proximal fistulas with interference in the sphincterian mechanisms may manifest themselves with continuos urinary incontinence or only after stress. The most distal fistulas are associated to complaints of non directional urinary flow or result in incontinence after urination. In these cases the urine falls into the vagina during urination and when the patient assumes an upright position, a urinary loss occurs. Eventually the fistula is asymptomatic and does not need treatment. Usually there exists a history of a provoked event for the appearance of symptoms, such as surgery in the region, childbirth, radiotherapy or external trauma, including urethral catheterism or the use of pessary for a long period of time. A critical evaluation is fundamental for the existence of stress urinary incontinence associated to a urethrovaginal fistula. In a series of 30 patients, carriers of urethral diverticulum or urethrovaginal fistula, treated by Fall3, 20% of the patients presented severe stress urinary incontinence with the need of a new surgical intervention. A significant number of patients (30%) presented light urinary incontinence, with no need of a specific treatment. Therefore, in the cases of associated stress urinary incontinence specific surgical procedures must be associated to the closing of the fistula. A critical examination of the urethra, and if necessary a urethrography and a urethrocystoscopy confirm the diagnosis.