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Total uterine prolapse complicated with vesicovaginal fistula: A case report
Ning-Shiuan Ting1, Hsiang-Chen Lee1, Jia-Ying Ke2
1Department of Obstetrics and Gynecology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation.
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.
