Progression of pressure ulcer to vesico-cutaneous fistula.

A 72-year-old female known to have diabetes, multiple medical problems, and bedridden with indwelling Foley's catheter. She presented with an ulcer which progressed to a Grade 4 pressure ulcer. She was known to have recurrent urinary tract infection. Contrast study through the fistula revealed a communicating fistula between the left buttock ulcer and the bladder. Conservative way of management was followed due to the overall health status of the patient. She was sent to home with daily dressings, mattress, and an occupational therapy plan. Fortunately, her fistula healed spontaneously after six months. To our knowledge, in addition to the unique presentation and outcome, the case we reported is the first with such communication.