Vol. 6, Issue 1, Part B (2024)

Rationale: Malignancy is the second most common cause of enterovesical fistula the standard treatment is excision of fistula with either primary repair or a temporary diverting colostomy. However in high risk cases major surgery can pose significant morbidity to the patient.

Patient concerns: A 78 year old lady with a history of cancer, diabetes, hypertension and colonic diverticulosis as admitted to the department of Urology, SSB Heart and Multispeciality hosp, Faridabad, Haryana ith distressing symptoms of passing fecal matter in her urine which posses both a health risk and significant impact on her quality of life. She also had a past history of chemotherapy and radiotherapy for cancer cervix.

Diagnosis: Contrast CT MCUG revealed a fistulous connection between the sigmoid colon and the urinary bladder.

Interventions: After counselling the patient of all possible options, the patient opted for the far less invasive holmium laser wielding of the fistulous tract despite the fact that it was a less tested option. The procedure lasted < 15 minutes. With no external cuts and the patient was fit to go home next day.

Outcomes: The result was immediate and at 6 months follow up the patient was found to have no recurrence of passing fecal matter in urine. Holmium laser has been used to close Vesico Vaginal Fistula in selected cases ith small fistula.

The treatment use of the complex urinary fistulas. It olula exemplifies underscores How innovative medical technologies can lead to better patient outcomes, offering less invasive, more efficient and highly effective treatment options.