Suprapubic-Vaginocutaneous Fistula 18 Years After a Bladder-Neck Suspension

Several complications are associated with healing after pelvic reconstructive surgery for stress urinary incontinence. These include infection, hemorrhage, erosion, and fistula formation. A 67-year-old woman presented with simultaneously draining vaginal and suprapubic sinuses. Examination revealed a vagino-abdominal fistula. Surgical excision found an abscess around synthetic material from a previous bladder-neck suspension. Unusual fistulation can occur remotely from anti-incontinence surgery, especially when graft materials are used.