Vesicovaginal Fistula Following Loop Electrosurgical Excision Procedure: A Case Report

Abstract

Background: The loop electrosurgical excision procedure (LEEP) is commonly used to treat cervical dysplasia and has few procedural risks. We report a rare complication: vesicovaginal fistula (VFF).

Case: A 47-year-old G3P1 woman with a previous LEEP underwent a second procedure 9 years later and was diagnosed as having microinvasive cervical cancer. Subsequently, at the time of her scheduled robotic-assisted laparoscopic total hysterectomy, examination under anaesthesia revealed a VFF, confirmed with cystoscopy. A joint VFF repair and total abdominal hysterectomy bilateral salpigo-oophorectomy subsequently ensued with an uncomplicated postoperative course.

Conclusion: VFF is a rare but recognized complication of LEEP, particularly in women with risk factors, such as a prior LEEP. Examination under anesthesia prior to commencing surgery facilitated recognition and appropriate management of this case.

Keywords: Vesicovaginal fistula; loop electrosurgical excision procedure; vaginal fistula.