Introduction Transvaginal mesh surgery can cause mesh complications including rare rectovaginal fistula. We report a case of a rectovaginal fistula treated transvaginally without colostomy. Case presentation A 57‐year‐old female was referred to us due to post‐hysterectomy prolapse and had transvaginal mesh surgery. She underwent transvaginal hysterectomy because of uterine prolapse at age 33 and had taken steroids to treat pemphigus. Two years later, she developed vaginal bleeding and discharge. Transvaginal mesh removal was planned to treat vaginal mesh exposure, but immediately before the operation digital rectal examination revealed rectovaginal fistula. Mesh removal and fistula closure were performed transvaginally without colostomy. Three years of follow‐up showed no recurrence of mesh exposure, fistula, or prolapse. Conclusion Rectovaginal fistula following mesh surgery may be treated transvaginally without colostomy if infection is minimal. To evaluate mesh exposure on the posterior vaginal wall, rectal examination should be done along with vaginal examination.
Introduction We encountered six post‐bath incontinence cases caused by bathwater entrapment in the vagina. Case presentation The age of onset was distributed from 16 to 78 (average 38) and five out of six patients were parous. Three patients developed post‐bath incontinence immediately after vaginal delivery. One patient developed post‐bath incontinence after beginning to bathe in a reclined position and another after undergoing transvaginal mesh surgery to treat prolapse. All patients showed dribbling incontinence without urgency limited to within 30 min after bathing. Patients were instructed to put a towel between their legs and apply abdominal pressure to evacuate the entrapped water. Additionally, they were advised to squat in the bathtub to prevent water entrapment. This simple behavioral therapy relieved symptoms. Conclusion The differential diagnosis of incontinence in women should include entrapped fluid incontinence such as bathwater incontinence, pool water incontinence, and vaginal reflux during micturition.
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