Management of a patient with vesicocutaneous fistula presenting 13 years after radiotherapy performed for cervical cancer.

A vesicocutaneous fistula (VCF) is a tract that is formed abnormally between the bladder and the external surface of the body. VCF results in a great deal of inconvenience, discomfort, and physical disability for the affected patient. This condition can be caused by extensive trauma with pelvic bone fracture, radical pelvic surgery, irradiation of pelvic malignancies, hip arthroplasty, a large bladder calculus, and various other pathologies. The management of VCF should be approached on a case-by-case basis because of the complexity of the disease. In this report, we present a case of VCF that was managed by using vacuum-assisted closure therapy. A 72-year-old female was diagnosed with VCF as a late complication after radiotherapy for cervical cancer. After radiotherapy, she had lower urinary tract symptoms and was diagnosed as a neurogenic bladder. She started to perform clean intermittent catheterization (CIC). She was subsequently diagnosed as chronic kidney disease stage 5 due to hypertensive nephrosclerosis, and started to receive hemodialysis. Recently, she avoided CIC because of decreased urine output. Despite urinary diversion and surgical debridement, the surgical wound had not healed after several days. After vacuum assisted closure therapy, the surgical wound healed and filled with granulation tissue. This case shows that vacuum-assisted closure therapy is efficient for complicated wound healing of a VCF after radiotherapy.