Annalyse Sabia

Burrell College of Osteopathic Medicine
United States

Abstract Title: Vesicouterine Fistula Complication Secondary to Untreated Stage IV Cervical Cancer

Biography:

Annalyse Sabia has completed her BS in Environmental Science at the University on North Carolina at Chapel Hill. She is currently an OMS-III at the Burrell College of Osteopathic Medicine in Las Cruces, New Mexico, and she will be applying for an OBGYN residency this upcoming fall.

Research Interest:

This case study examines a 62-year-old woman whose late-stage cervical cancer went undiagnosed for months due to what seemed like an atypical cancer presentation. She initially sought care for recurrent UTIs, which were treated with antibiotics by her primary care physician. Over eight months, her symptoms worsened, including hydronephrosis and unintended weight loss. Despite suspicious CT findings of a vesicouterine fistula, her diagnosis remained elusive.

Vesicouterine fistulas are rare, particularly in patients without pelvic surgery. Given the lack of postmenopausal bleeding, her urinary symptoms led to diagnostic anchoring, delaying her referral to a gynecologist. Ultimately, a transvaginal ultrasound revealed a large uterine mass, and pathology confirmed Stage IV cervical cancer with vesicouterine fistula formation.

This case underscores the dangers of diagnostic bias and highlights the need for a broader differential, particularly for patients with recurrent or unexplained symptoms. It also highlights that many cancers present differently from what is expected or routine, and a more holistic evaluation could have led to earlier cancer detection, potentially altering her prognosis.

In researching this case, I reviewed her medical history and explored literature on late-stage cervical cancer symptoms–such as those seemingly “atypical” features that this patient presented with, vesicouterine fistulas, and the global impact of pap smear screening. My goal with this case study is twofold: First, to emphasize the necessity of a multidisciplinary approach in medicine, ensuring that patients with persistent and unexplained symptoms receive comprehensive evaluations across specialties. Second, to contribute to the medical community’s understanding of vesicouterine fistulas as a rare yet possible complication of advanced cervical cancer. Ultimately, this case underscores the critical role of early screening and disease prevention—because, tragically, cases like this are often preventable when patients have access to and adhere to routine gynecologic care.