**Core Concept**
A simple vesicovaginal fistula is an abnormal connection between the bladder and vagina, resulting from damage to the tissues separating these two organs. This condition leads to continuous urinary leakage from the vagina, causing significant distress to the affected individual.

**Why the Correct Answer is Right**
The correct answer is related to the characteristics of a simple vesicovaginal fistula. A simple fistula is typically a small, direct connection between the bladder and vagina, usually resulting from a single traumatic event, such as childbirth or surgery. This type of fistula usually has a well-defined opening and a narrow, tubular tract.

**Why Each Wrong Option is Incorrect**
* **Option A:** This option is incorrect because it doesn't describe the typical characteristics of a simple vesicovaginal fistula. A complex fistula would have a larger, more irregular opening and may involve multiple tracts or tissues.
* **Option B:** This option is incorrect because it's a feature more commonly associated with complex or high-pressure fistulas, which are less likely to be simple.
* **Option C:** This option is incorrect because it's a characteristic of a complex fistula, where the tract is often wider and more irregular.

**Clinical Pearl / High-Yield Fact**
Simple vesicovaginal fistulas are typically amenable to repair through a variety of surgical techniques, including transvaginal and abdominal approaches. Prompt recognition and treatment are essential to restore urinary continence and improve quality of life.

**Correct Answer:** D