Endoscopic Treatment of a Colovesical Fistula Using a Through-The-Scope Clip Designed for Large Defect Closure

We present a patient who underwent endoscopic treatment of a colovesical fistula (CVF) using a through-the-scope clip (TTSC) designed for large defect closure. She was admitted for recurrent urosepsis. She declined surgery but agreed for endoscopic therapy. An over-the-scope clip was not used as the CVF was in close proximity to the right vesicoureteric junction. Conventional TTSCs failed to close the CVF due to fibrotic tissue at the CVF opening. A TTSC designed for large defect closure (MANTIS Clip, Boston Scientific, Marlborough, MA) successfully closed the CVF. The patient was last reviewed 9 months after endoscopic closure, with no further episodes of urosepsis.