Total uterine prolapse complicated with vesicovaginal fistula: A case report

Medicine (Baltimore). 2021 Jun 18;100(24):e26386. doi: 10.1097/MD.0000000000026386.

Abstract

Rationale: Vesicovaginal fistula (VVF) most commonly occurs due to iatrogenic injury during surgery or obstructed labor. We report a rare case of a patient with severe pelvic organ prolapse who developed VVF even though pessary had not been used.

Patient concerns: A 63-year-old postmenopausal woman, para 3 (all spontaneous vaginal deliveries), complained of vaginal bulging sensation and involuntary urinary leakage for 3 years.

Diagnosis: Stage IV uterine prolapse with VVF.

Interventions: She underwent transvaginal VVF repair combined with total vaginal hysterectomy and sacrospinous ligament fixation. The postoperative course was uncomplicated.

Outcomes: The patient remained free of complications during the 1-year follow-up.

Lessons: This case illustrates the point that patients with pelvic organ prolapse (POP) should be treated promptly and careful follow-up should be conducted. Clinicians should be aware of the symptoms of VVF to ensure its early diagnosis and treatment.

Publication types

  • Case Reports

MeSH terms

  • Female
  • Humans
  • Hysterectomy, Vaginal
  • Ligaments / surgery
  • Middle Aged
  • Urination Disorders / etiology
  • Uterine Prolapse / complications*
  • Uterine Prolapse / surgery
  • Vesicovaginal Fistula / complications*
  • Vesicovaginal Fistula / surgery