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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.
Tsunekawa et al. (Mon,) studied this question.