Vesicovaginal fistula following large‐loop excision of the transformation zone in a chronic systemic glucocorticoid user

Abstract

A 42-year-old woman with a history of a large-loop excision of transformation zone for cervical intraepithelial neoplasia III four years previously visited our outpatient department for cervical intraepithelial neoplasia I that newly detected by colposcopy-directed punch biopsy. Her other medical conditions include systemic lupus erythematosus on daily prednisolone 15 mg during 19 years. After second large-loop excision of transformation zone, delayed vesicovaginal fistula was confirmed by indigo carmine leakage test, computed tomography scan, and cystoscopy. Fistula was primarily repaired with indwelling double-J catheters with anchoring omentum on suture site.

Efficacy of loop electrosurgical excision procedure with cold coagulation for treating cervical intraepithelial neoplasia: A two center cohort study

“…Thus, repeated conization is considered whenever resection margin of specimen is positive after LEEP for obtaining specimen without residual dysplastic cells [11]. Nevertheless, repeated conization is discouraged for young women who want pregnancy because it increase the risk of preterm birth [1213], and for women who show no residual cervix because repeated conization increases post-procedure complications such as vesicovaginal fistula [14]. …”