OBJECTIVE: We tested a new MDCT technical protocol, combining i.v. and intravesical positive contrast agent and intravaginal neutral contrast agent, that optimizes exploration of urogenital fistulas. We examined three patients (four CT examinations in total) with this technique and proved that a preexisting subtle ureterovaginal fistula that was under treatment was still present, though clinically silent. CONCLUSION: The proposed MDCT examination protocol provides important information to help detect subtle urogenital fistulas.