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Persistent Vaginal Leakage in the Setting of an Apical Vaginal Sinus Tract: A Case Report

Bastawros, Dina, MD*; Beano, Hamza, MD; Kennelly, Michael J., MD*†; Stepp, Kevin J.E., MD*

Female Pelvic Medicine & Reconstructive Surgery: July/August 2018 - Volume 24 - Issue 4 - p e23–e25
doi: 10.1097/SPV.0000000000000600
Case Reports

Fistulas are defined as abnormal connections between 2 organ, vessels, or structures. They can often present in the genitourinary tract as a result of iatrogenic injury during pelvic surgery. A 46-year-old female presents many years after a hysterectomy for persistent vaginal leakage with concern for a vesicovaginal fistula. Computed tomography urogram, intravenous retrograde pyelogram, and cystoscopy were negative for vesicovaginal fistula; however, a vaginal sinus tract was noted and further explored. This case report will describe the use of both laparoscopy and concomitant vaginoscopy to diagnose and, ultimately, surgically excise a salpingovaginal fistula.

A salpingovaginal fistula can successfully be identified and excised using concomitant laparoscopy and vaginoscopy with a ureteroscope.

From the *Department of Obstetrics and Gynecology, Division of Female Pelvic Medicine and Reconstructive Surgery, and

Department of Urology, Carolinas HealthCare System, Charlotte, NC.

Correspondence: Dina Bastawros, MD, 2001 Vail Ave, Suite 360 Charlotte, NC 28207. E-mail:

D.B. and H.B. have no conflicts of interest. M.J.K. reports grants and personal fees from Allergan, grants and personal fees from Boston Scientific, grants and personal fees from Coloplast, grants from Ipsen, grants from Amphora, grants from Dignify Therapeutics, and personal fees from Cogentix. K.J.S. is a speaker for Sciton and was a consultant for ConMed.

Presented at the American Urogynecologic Society 38th Scientific Meeting, October 3–7, 2017, Providence, RI, and the American Association of Gynecologic Laparoscopists 46th Scientific Meeting, November 12–16, 2017, National Harbor, MD.

This study received EXEMPT status from the Carolinas HealthCare System IRB on April 6, 2017. Below is the IRB number for this research.

IRB number: 04-17-05EX (date: April 6, 2017).

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