Total uterine prolapse complicated with vesicovaginal fistula: A case report.

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.