# Case Report: SVF after chemoradiotherapy for cervical cancer diagnosed by non-contact hysteroscopic technique

## TL;DR

A rare case of a sigmoidovaginal fistula after cervical cancer treatment was successfully diagnosed using a non-contact hysteroscopic technique when other methods failed.

## Contribution

The paper introduces a non-contact hysteroscopic technique as an effective diagnostic tool for complex sigmoidovaginal fistulas.

## Key findings

- Conventional diagnostic methods failed to locate the fistula in a patient with cervical cancer.
- A non-contact hysteroscopic technique successfully identified the fistula's location, size, and number.
- The method is particularly useful for postmenopausal women and those with complex fistulas from cancer treatment.

## Abstract

Sigmoidovaginal fistula (SVF) is an extremely distressing and complex condition that significantly impacts a patient’s quality of life. The successful management of SVF relies on accurately identifying the fistula’s location and tract. However, preoperative localization can be challenging in certain cases. In this report, we describe a rare complication in a patient with stage IVA cervical cancer who developed SVF after concurrent chemoradiotherapy. Conventional diagnostic methods, including electron colonoscopy, methylene blue testing, and fistulography, were unable to locate the fistula. As an alternative, we used a non-contact hysteroscopic technique, which successfully identified the location, size, and number of fistulas. This method is particularly effective for patients with SVF, especially in postmenopausal women with narrowed or adherent vaginal tracts, women with intact hymen, and those with complex, high-grade vaginal fistulas resulting from cancer treatment with chemoradiotherapy.