Bilateral Ureterovaginal Fistulas and Vesicovaginal Fistula in Setting of Retained Pessary

Urogenital fistulas in the setting of foreign body are rare. Isolated vesicovaginal fistula is the most common and has been reported in the setting of retained intraureterine device,^1,2 neglected pessary^3,4 and atypical insertions related mostly to sexual activity or underlying psychiatric disorders.^5-7 Combined vesicovaginal and ureterovaginal fistulas related to foreign body are extremely rare. To our knowledge, we present the first reported case of bilateral ureterovaginal fistula and concurrent vesicovaginal fistula in the setting of retained pessary.