A 42-year-old female with an ASA score III and a BMI of 24 was diagnosed with Stage IIIB serous papillary carcinoma of the ovary in 2009. She underwent multiple open surgeries with extensive resection, including hysterectomy, double oophorectomy, omentectomy, right colectomy, peritonectomy and hyperthermic intraperitoneal chemotherapy.
Due to a large implant on the sigmoid, a colonic stent was placed in April 2016. However, due to proximal stent migration, surgery was required. A colostomy was performed but the stent could not be removed. The patient continued with chemotherapy but six months later she presented with urinary symptoms. During the work-up, a foreign body was identified in the bladder, which was compatible with the colonic stent.
After a interdisciplinary discussion among the Gynecology, General Surgery and Urology teams, the consensus decision was to attempt a minimally invasive approach through a cystoscopy in the first place, given the fragile status of the patient, added to the multiple surgeries she had previously undergone. The stent was successfully removed through a cystoscopy by the Urology team.
Presumably, a large sigmoidovesical fistula had been created, allowing the passing of the stent into the bladder and causing the patient’s urinary symptoms. The urinary symptoms were controlled after the stent was removed, and the colostomy was still functional, so no other invasive procedures were indicated for this patient.
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