Colovaginal Fistula in a Patient Without Diverticular Disease or Prior Hysterectomy: A Case Report.

Colovaginal fistulas are abnormal communications between the colon and vagina that typically present with the passage of flatus or fecal material through the vagina and usually require surgical repair. Most cases occur in association with diverticular disease or a prior hysterectomy; occurrence in the absence of these risk factors is uncommon and may delay diagnosis. We present the case of a 69-year-old woman with a colovaginal fistula despite the absence of diverticular disease and a history of prior hysterectomy. She underwent successful multidisciplinary surgical management involving Urology, Gynecology, and General Surgery, followed by a favorable postoperative recovery. This report highlights the importance of considering colovaginal fistula in elderly patients presenting with feculent vaginal discharge, even in the absence of traditional risk factors, and demonstrates the value of coordinated multidisciplinary management in atypical presentations.