Tsunekawa Ryoken, Wada Naoki, Takagi Haruka, Hatakeyama Tsubasa, Nagabuchi Masaya, Morishita Shun, Ichikawa Hidetoshi
Department of Renal and Urologic Surgery Asahikawa Medical University Asahikawa Japan.
Department of Obstetrics and Gynaecology Asahikawa Medical University Asahikawa Japan.
IJU Case Rep. 2025 Jul 28;8(5):458-461. doi: 10.1002/iju5.70064. eCollection 2025 Sep.
We report a case of bladder eversion through a vesicovaginal fistula (VVF) in an elderly patient with severe pelvic organ prolapse (POP).
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.
In elderly patients, VVF can develop in advanced POP. Minimally invasive treatment is desirable, and early intervention for POP may help prevent this complication.
我们报告了一例老年严重盆腔器官脱垂（POP）患者经膀胱阴道瘘（VVF）发生膀胱外翻的病例。
一名90岁女性出现脱垂感和尿漏。经诊断，她患有完全性子宫脱垂并经VVF出现膀胱黏膜外翻，因双侧肾积水导致肾功能不全。进行了一期微创手术修复。然后分两层关闭VVF，并用Martius皮瓣加固。未加做经阴道子宫切除术而行阴道封闭术。术后18个月，患者未再出现POP和尿失禁。
在老年患者中，VVF可在重度POP中发生。微创治疗是可取的，对POP的早期干预可能有助于预防这种并发症。
