• Ning-Shiuan Ting, Hsiang-Chen Lee, Jia-Ying Ke, Pei-Chen Li, and Dah-Ching Ding.
• Department of Obstetrics and Gynecology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation.
• Medicine (Baltimore). 2021 Jun 18; 100 (24): e26386e26386.

RationaleVesicovaginal fistula (VVF) most commonly occurs due to iatrogenic injury during surgery or obstructed labor. We report a rare case of a patient with severe pelvic organ prolapse who developed VVF even though pessary had not been used.Patient ConcernsA 63-year-old postmenopausal woman, para 3 (all spontaneous vaginal deliveries), complained of vaginal bulging sensation and involuntary urinary leakage for 3 years.DiagnosisStage IV uterine prolapse with VVF.InterventionsShe underwent transvaginal VVF repair combined with total vaginal hysterectomy and sacrospinous ligament fixation. The postoperative course was uncomplicated.OutcomesThe patient remained free of complications during the 1-year follow-up.LessonsThis case illustrates the point that patients with pelvic organ prolapse (POP) should be treated promptly and careful follow-up should be conducted. Clinicians should be aware of the symptoms of VVF to ensure its early diagnosis and treatment.Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc.

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