Post-traumatic bilateral vesicocutaneous fistula of thighs treated with buccal mucosa graft urethroplasty and cyanoacrylate glue instillation: a novel treatment for management of a complicated fistula

Abstract

Post-traumatic vesicocutaneous fistula (VCF) is a rare variant of urinary fistulas. These fistulas may externally communicate to abdomen, perineum, buttocks, scrotum or very rarely thigh. These fistulas usually develop at a variable time duration after trauma and are usually preceded with thigh swelling or abscess formation followed by spontaneous rupture. We, hereby, report a case of VCF of bilateral thighs with associated penobulbar urethral stricture after road traffic accident which was managed with dual modality of buccal mucosa graft urethroplasty surgery and cyanoacrylate glue injection in the fistulous tracts. To the best of our knowledge, this is first report of bilateral VCFs communicating externally to thighs. In literature, very few cases of VCFs of thigh are reported and are rarely managed with adhesive glue application.

Management of an intrathecal baclofen pump pocket empyema caused by a proximal vesicocutaneous fistula: A case report

“…[4,7] Vesicocutaneous fistulas are very rare clinical entities, which divert the urinary stream from the urinary bladder directly to the overlying skin. Risk factors for the formation of such fistulas include gynecological surgery or traumatic injuries, [1] UTIs and urinary retention (neurogenic or structural). [12,20] Consistently, our patient's medical history included a cesarean section, recurrent UTIs, and bladder distention due to her MS.…”

An unusual presentation of penetrating bladder injury with vesicocutaneous fistula: a case report

“…Vesicocutaneous fistulas rarely communicate to the thigh but commonly exit the perineum, scrotum, buttocks or hypogastrium [12]. The time for the fistula to develop can be variable but usually precede an abscess [12].…”