Patient records
Name: Nguyen Thi Lan
Age: 45
Nationality: Vietnam (Ho Chi Minh City)
Diagnosis: Complex vesicovaginal fistula (post-hysterectomy complication, fistula opening approximately 1.5cm, located near the trigone of the bladder)
Treatment Hospital: Renji Hospital Affiliated to Shanghai Jiao Tong University School of Medicine—Department of Urology/Obstetrics and Gynecology
In the video Ms. Lan sent, she was wearing a beautiful ao dai, smiling and posing for photos on the streets of Ho Chi Minh City. Her smile was confident and composed, a stark contrast to the woman who a year ago was afraid to go out or socialize. In her email, she wrote, "Thank you for helping me restore my 'leaked' dignity."
Ms. Lan's nightmare began with a hysterectomy performed locally. Shortly after the surgery, she discovered that urine was involuntarily leaking from her vagina. The examination results were devastating: during the surgery, her bladder had been accidentally damaged, creating a vesicovaginal fistula. This meant that an abnormal passage had formed between her bladder and vagina, causing uncontrollable urine leakage. She had to wear adult diapers 24 hours a day and always had an unpleasant odor. She was afraid to go out, afraid to socialize, and even afraid to be close to her child, plunging into deep depression.
In Vietnam, she attempted a transvaginal repair surgery, but the procedure failed due to the complex location of the fistula, close to the ureteral opening. When Ms. Lan's family contacted Renji Hospital through us, they were almost clinging to a last hope. Our case manager understood that this was not only a technical challenge but also a process requiring psychological reconstruction. We quickly connected her with Renji Hospital, affiliated with Shanghai Jiao Tong University School of Medicine, where the urology and gynecology repair team is a nationally recognized authority in treating complex urinary fistulas.
Before the consultation, we organized a remote consultation. Renji Hospital's expert team used the CT and cystoscopy images we transmitted to accurately assess the location, size, and surrounding tissue condition of the fistula. Our medical consultant explained to her, "Because the location of the fistula is tricky, the doctor will use a transabdominal surgical approach to find the 'hole' between the bladder and vagina, and then use a piece of vascularized fatty tissue from your own abdominal cavity—the greater omentum—to fill the gap like a 'living patch,' using fresh blood supply to promote healing."
The surgery was performed with meticulous care. The surgeon carefully separated the adhesions between the bladder and vagina, located the 1.5-centimeter fistula, and performed tension-free sutures. Subsequently, the microsurgical team freed a pedicled omental flap with a rich blood supply and precisely filled it between the bladder and vagina, providing a solid guarantee for the fistula's healing.
During the post-treatment and follow-up phases , our case manager provided Ms. Lan with meticulous care. We guided her through bladder function training and arranged for a remote psychological counselor to provide support. After returning to China, she regularly uploaded her voiding diary through our app. Three weeks after the surgery, when the catheter was removed and the fistula was confirmed to be completely healed and no longer leaking urine, she broke down in tears on the other end of the video call. She said that it was the Chinese doctors who helped her restore her "leaked" dignity and gave her a new lease on life.