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Bladder Eversion Through a Vesicovaginal Fistula in a Patient With Complete Uterine Prolapse
Ryoken Tsunekawa1, Naoki Wada1, Haruka Takagi1
1Department of Renal and Urologic Surgery Asahikawa Medical University Asahikawa Japan.
Introduction:
We report a case of bladder eversion through a vesicovaginal fistula (VVF) in an elderly patient with severe pelvic organ prolapse (POP).
Case Presentation:
A 90-year-old woman presented with a sensation of prolapse and urinary leakage. She was diagnosed with complete uterine prolapse and bladder mucosal ectropion through a VVF, with renal dysfunction due to bilateral hydronephrosis. A one-stage minimally invasive surgical repair was performed. The VVF was then closed in two layers and reinforced with a Martius flap. Colpocleisis was performed without the addition of transvaginal hysterectomy. At 18 months after surgery, the patient remained free of POP and urinary incontinence.
Conclusion:
In elderly patients, VVF can develop in advanced POP. Minimally invasive treatment is desirable, and early intervention for POP may help prevent this complication.
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