IJU case reports · 2026
Simultaneous Ureterovaginal and Rectovaginal Fistulas Caused by a Cube Pessary: A Case Report.
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Yano Tetsuhiro, Sasaki Yutaro, Kinouchi Riyo, Kashihara Hideya, Itami Haruka, Kobayashi Saki, Fukawa Tomoya, Iwasa Takeshi, Soyama Akihiko, Furukawa Junya
Аннотация
INTRODUCTION: We present a case of simultaneous ureterovaginal and rectovaginal fistulas caused by continuous placement of a cube pessary without daily removal, successfully managed through a multidisciplinary approach.
CASE PRESENTATION: An 84-year-old female managed with a cube pessary presented with hematochezia. Initial imaging revealed simultaneous pessary penetration into the rectum and right ureterovesical junction. A previous hospital first performed a sigmoid colostomy and an unsuccessful transvaginal rectovaginal fistula closure. Following this, a ureteral stent was placed for the ureterovaginal fistula, but it also failed to close due to extensive tissue defects. She was referred to our hospital, where a multidisciplinary surgery incorporating retroperitoneal extravesical ureteroneocystostomy, transvaginal fistula closure, and anterior colporrhaphy was performed.
CONCLUSION: Cube pessaries require daily self-management, and continuous placement in elderly patients can lead to severe ischemic complications. Multidisciplinary surgical reconstruction is crucial to preserve renal function and restore quality of life.
CASE PRESENTATION: An 84-year-old female managed with a cube pessary presented with hematochezia. Initial imaging revealed simultaneous pessary penetration into the rectum and right ureterovesical junction. A previous hospital first performed a sigmoid colostomy and an unsuccessful transvaginal rectovaginal fistula closure. Following this, a ureteral stent was placed for the ureterovaginal fistula, but it also failed to close due to extensive tissue defects. She was referred to our hospital, where a multidisciplinary surgery incorporating retroperitoneal extravesical ureteroneocystostomy, transvaginal fistula closure, and anterior colporrhaphy was performed.
CONCLUSION: Cube pessaries require daily self-management, and continuous placement in elderly patients can lead to severe ischemic complications. Multidisciplinary surgical reconstruction is crucial to preserve renal function and restore quality of life.