A Rare Case of Combined Vesico-Vaginal and Vesico-Cutaneous Fistulae Treated by One-Stage Surgical Repair

Abstract

Combined vesico-vaginal and vesico-cutaneous fistulae are exceptionally rare. We present a young woman who had combined vesico-vaginal fistula and vesico-cutaneous fistula following prolonged obstructed labour and caesarean section. The patient presented at three months of illness with total urine incontinence from the vagina and lower abdominal skin. One-stage surgical repair of both fistulae was done. The patient had a successful closure of the fistulae, regained full urinary continence, and remained continent at six months follow-up. We opine that one-stage repair of combined vesico-vaginal and vesico-cutaneous fistulae is feasible and preferred. Providers of pelvic surgery in low resource countries should be supervised and retrained accordingly, in order to prevent iatrogenic vesico-cutaneous fistula.