Post-radiation vesicovaginal fistula — multidisciplinary management station

Station brief

Format. Outpatient multidisciplinary station, approximately 12 minutes. You are the urogynaecology fellow in a tertiary combined clinic with the radiation oncologist, colorectal surgeon and pelvic floor physiotherapist. The patient is 9 months post-chemoradiation, distressed, socially isolated, and considering permanent urinary diversion. The assessor will run the clock and feed you clinical information.^[1][2]

Candidate instruction. Take a focused history of the fistula and its impact, propose your management plan, defend the choice of operative approach with vascularised interposition, and outline your multidisciplinary care including psychosocial support, the realistic chance of continence and the option of urinary diversion.^[1][2][3]