Bladder Eversion Through a Vesicovaginal Fistula in a Patient With Complete Uterine Prolapse

Q4 Medicine

IJU Case Reports Pub Date : 2025-07-28 DOI:10.1002/iju5.70064

Ryoken Tsunekawa, Naoki Wada, Haruka Takagi, Tsubasa Hatakeyama, Masaya Nagabuchi, Shun Morishita, Hidetoshi Ichikawa

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Abstract

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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完全性子宫脱垂患者膀胱外翻经膀胱阴道瘘一例

我们报告一例膀胱外翻经膀胱阴道瘘（VVF）在一个老年患者严重盆腔器官脱垂（POP）。病例介绍一名90岁女性，以脱垂和尿漏的感觉为主诉。经VVF诊断为完全性子宫脱垂和膀胱粘膜外翻，双侧肾积水导致肾功能不全。采用一期微创手术修复。然后将VVF关闭为两层并用马蒂乌斯皮瓣加固。阴道冲洗术不加经阴道子宫切除术。术后18个月，患者无POP和尿失禁。结论老年晚期POP患者可发生VVF。微创治疗是可取的，早期干预可能有助于预防这种并发症。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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