Vesicocutaneous fistulas (VCF) are a rare complication of radical radiotherapy to the pelvis.
Timely diagnosis and management are often difficult and complex. We report the unusual case of a 64-year-old gentleman who presented to the emergency department with worsening sepsis and profuse discharge from a cutaneous opening in the left groin. This presentation was 6 weeks following the completion of external beam radiotherapy for apical margin-positive prostate cancer (pT3a). A diagnosis of a VCF was confirmed after CT scanning of the abdomen and pelvis with contrast. Urinary diversion was achieved by a temporary urethral catheter insertion. Full resolution of this gentleman's symptoms was accomplished. In this article, we present a non-invasive approach to the management of VCF. This case raises intricate management issues in the atypical development of an early urinary tract fistula postradiotherapy.
Hennessey DB, Bolton E, Thomas AZ, Lynch TH. Are you the author?
Department of Urology, Craigavon Area Hospital, Portadown, UK.
Reference: BMJ Case Rep. 2013 Apr 25;2013. pii: bcr2013008986.