Very Late Onset of Radiation-induced Complicated Vesicocutaneous Fistula

Vesicocutaneous fistula (VCF) secondary to radiation therapy is a rare event. There are difficulties in establishing the early diagnosis and choosing the proper management option. We present a very unusual case of postradiotherapy vesicocutaneous fistula which developed more than 30 years later. Temporary urinary diversion was performed because of poor performance status and anatomical condition. However, it failed to achieve spontaneous closure of VCF. It is important to recognize that late onset of radiation induced VCF could develop even after a substantial period of time has lapsed. In addition, conservative treatment appears to be unsuccessful in patient with complicated VCF. Therefore, it must be counselled carefully after a making synthetic judgment based on different individual situation.