Simultaneous Repair of Sigmoid Colon Conduit Fistula and Neovagina Construction in a Patient with Bladder Exstrophy

Recurrent urogynecologic complications in women with bladder exstrophy are common and complex given the congenital abnormalities of the bony, connective tissue, and muscular support of the pelvic floor, as well as the length and axis of the vagina. Management of these issues is challenging and often requires unique surgical strategies. We present the case of a distinct, individualized surgical approach to management of several complicated urogynecologic issues in a woman with bladder exstrophy who desired surgical correction of a non-healing fistula, pelvic organ prolapse, and a short vagina.