PMC9057226_01
Suburethral haematoma above the vesico-vaginal fistula.
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There was a suburethral haematoma above a 2 cm vesico-vaginal fistula (Figure 1).
(A) Disappearance of the sub urethral haematoma. (B) Semi-circumferential vesico-urethrovaginal fistula.
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After two weeks of conservative measures, the edges of the fistula became clean and rosy, delineating a semi-circumferential fistula involving a portion of the trigone, the bladder neck and the urethra (Figure 2). The urethral length was 1.3cm, the vesico-vaginal fistula size was 3.5cm with the ureters situated 0.5 cm from the edge (Figure 2).
Microscopic aspect of lobular capillary hemangioma.
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The dermis was characterized by extensive angiogenic activity, congestion and mixed moderate inflammatory infiltrates diagnostic of lobular capillary hemangioma (Figure 3).
Surgical management of the fistula.
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We performed a repair of the vesico-urethro-vaginal fistula (Figure 4), using sharp dissection after the incision around the edge of the fistula.
Final aspect after fistula repair (vaginal closure).
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After a negative dye test, the vaginal mucosa was closed (Figure 5).