This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: Genital Prolapse - various presentation of prolapse and management of urinary stress incontinence (I am hanging by my nails !), Subject name: Gynaecology & Obstetrics
The most common cause of vesicovaginal fistula(VVF) in under-developed countries would be: 
Select and explain. 
A. Obstetrical injury, B. Pelvic irradiation, C. Carcinoma, D. Haemorrhoidectomy
A: Obstetrical injury
Answer: A: Obstetrical injury 
Explanation: Causes of vesico vaginal fistula: Gynaecological Surgery: Most common cause in developed countries Obstetric injury/ Obstructed labour (leading to tissue necrosis): Most common cause in developing countries Radiation Malignancy Foreign bodies: forgotten pessaries Direct trauma Infective: TB, schistosomiasis, syphilis, LGV Endometriosis, perforating bladder calculi