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Delayed vesicovaginal fistula after ring pessary usage
Katherine Jane Penrose1, Jessica Ma Yin, Nicolas Tsokos
1Department of Urogynaecology, King Edward Memorial Hospital, Subiaco, WA, Australia, katherine.penrose@health.wa.gov.au.
International Urogynecology Journal
|June 27, 2013
Summary
Vaginal ring pessaries can cause rare but serious complications like fistulas. Meticulous follow-up after pessary removal is crucial, especially if ulceration is present, to prevent delayed genitourinary issues.
Area of Science:
- Urology
- Gynecology
- Medical Case Reports
Background:
- Vaginal pessaries are widely used for pelvic organ prolapse management, considered safe alternatives to surgery.
- Complications are rare but can occur due to improper fitting or maintenance of pessaries.
Observation:
- This case report details a delayed vesicovaginal fistula (VVF) developing 8 months post-removal of a ring pessary, following noted vaginal ulceration.
- The patient, an 82-year-old female, experienced a genitourinary fistula attributed to the vaginal ring pessary.
Findings:
- The delayed VVF was successfully managed with a urinary diversion using an ileal conduit.
- This represents the third documented instance of a genitourinary fistula linked to a vaginal ring pessary.
Implications:
- Highlights the critical need for diligent patient follow-up after pessary removal, particularly in cases with pre-existing vaginal ulceration.
- This case is the first to report successful management of such a fistula using an ileal conduit diversion.
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