A rare case of vasculitis ANCA of bladder and urethra providing to vesicovaginal fistula and early recurrence of illness

Abstract

Introduction: Vasculitis of the bladder and urethra is a rare disease. Its presentation, as a pelvis tumor, indicates the cancerous nature of the lesion. An incorrect diagnosis can result in the removal of the bladder. Case Presentation: We described a 56-year-old woman (born in 1964) with a vesicovaginal fistula, which arose from vasculitis ANCA. Establishing the correct diagnosis was a long and complicated process. During diagnosis, a urogenital fistula was created due to the deepening of inflammatory necrotic lesions. Remission was achieved by pharmacological treatment. As a result, fistula surgical treatment became possible. An unexpected relapse of vasculitis was diagnosed based on the bladder emptying symptoms. Repeat-ing the treatment resulted in a complete response. Eventually, we obtained a cure of regional vasculitis while maintaining the bladder and urethra, which translated into an increased quality of life for the patient. Conclusions: Correct diagnosis before surgery is of crucial importance. Combined pharmacology and surgery prevents removal of the bladder. Careful observation of symptoms allowed for the early detection of recurrent vasculitis.