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The purpose of writing this manuscript is to awaken the affected women and the dealing gynaecologists to enable them suspect, think, detect and then manage the ongoing overlooked ultra-micro vesico-vaginal fistulas (VVFs). Detailed history, thorough examination, and specific investigations are required to know all the characteristics of such genito-urinary fistulas. Modalities of management of such ultra-micro genito-urinary fistulas do not merely depend upon the facilities available in the treating center but mainly on the experience and expertise of the treating surgeon and the characteristics of the fistulas, because there is no consensus of opinion about any one particular procedure suitable for all types of the VVFs in the presence of different characteristics of fistulas and the signs and symptomatology of the affected women. [ABSTRACT FROM AUTHOR]