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Case Report
Concomitant repair of a complex rectovesicovaginal fistula following extensive pelvic surgery: A case report
1 College of Medicine, Taibah University, Medina, Saudi Arabia
2 Medina Health Cluster, Medina, Saudi Arabia
3 Department of Surgery, King Faisal Specialist Hospital and Research Centre, Medina, Saudi Arabia
4 Department of Urology, Faculty of Medicine, Assiut University, Egypt
5 Section of Surgery, King Faisal Specialist Hospital and Research Centre, Medina, Saudi Arabia
Address correspondence to:
Amr Mahran
King Faisal Specialist Hospital and Research Centre, Medina,
Saudi Arabia
Message to Corresponding Author
Article ID: 100063Z15AB2026
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Badawi A, Aloufi H, Almuzaini M, Mohiuddin M, Mahran A, Ghazi A. Concomitant repair of a complex rectovesicovaginal fistula following extensive pelvic surgery: A case report. J Case Rep Images Urol 2026;11(1):21–25.ABSTRACT
Introduction: Complex pelvic fistulae involving the genitourinary and the gastrointestinal tracts represent a rare but serious complication following extensive pelvic surgery. Management of such conditions could be challenging due to the disrupted anatomy and multidisciplinary involvement.
Case Report: We are reporting a case of a 41-year-old female with a long-standing history of endometriosis, recurrent ovarian endometriomas, and multiple pelvic surgeries who developed a combined vesicovaginal and rectovaginal fistula manifesting as continuous urinary and fecal leakage. Two fistulous tracts were identified in imaging and endoscopic evaluation connecting the posterior bladder wall, vaginal vault, and rectal stump. Both fistulae were repaired simultaneously via the transabdominal approach where multidisciplinary teams including urology and colorectal surgery were involved. The patient remained continent and asymptomatic in her subsequent follow-up appointments.
Conclusion: Concomitant repair of rectovesicovaginal fistulae is feasible and safe in selected patients via thorough multidisciplinary approach, adequate imaging, and individualized surgical intervention.
Keywords: Complex fistula, Rectovaginal fistula, Vesicovaginal fistula
SUPPORTING INFORMATION
Acknowledgments
Manus 1.6 AI was used to generate an illustrative diagram of the fistula.
Author ContributionsAhmad Badawi - Acquisition of data, Analysis of data, Drafting the work, Revising the work critically for important intellectual content, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Hussam Aloufi - Acquisition of data, Analysis of data, Drafting the work, Revising the work critically for important intellectual content, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Mohammed Almuzaini - Acquisition of data, Analysis of data, Drafting the work, Revising the work critically for important intellectual content, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Mohamed Mohiuddin - Conception of the work, Design of the work, Drafting the work, Revising the work critically for important intellectual content, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Amr Mahran - Conception of the work, Design of the work, Acquisition of data, Analysis of data, Drafting the work, Revising the work critically for important intellectual content, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Abdullah Ghazi - Conception of the work, Design of the work, Drafting the work, Revising the work critically for important intellectual content, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Guaranter of SubmissionThe corresponding author is the guarantor of submission.
Source of SupportNone
Consent StatementWritten informed consent was obtained from the patient for publication of this article.
Data AvailabilityAll relevant data are within the paper and its Supporting Information files.
Conflict of InterestAuthors declare no conflict of interest.
Copyright© 2026 Ahmad Badawi et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.
