Vesicocutaneous fistula following adjuvant radiotherapy for prostate cancer

BMJ Case Rep. 2013 Apr 25:2013:bcr2013008986. doi: 10.1136/bcr-2013-008986.

Abstract

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.

Publication types

  • Case Reports

MeSH terms

  • Cutaneous Fistula / diagnosis*
  • Cutaneous Fistula / therapy
  • Humans
  • Male
  • Middle Aged
  • Prostatic Neoplasms / radiotherapy*
  • Radiation Injuries / diagnosis*
  • Radiation Injuries / therapy
  • Radiotherapy, Adjuvant / adverse effects*
  • Tomography, X-Ray Computed
  • Urinary Fistula / diagnosis*
  • Urinary Fistula / therapy