Abstract
Vesico-vaginal fistula (VVF) is a debilitating complication commonly occurring after gynecologic surgery and frequently associated with significant morbidity and impaired quality of life. Although surgical repair remains the standard treatment, management strategies remain heterogeneous, while conservative approaches often require prolonged urinary diversion with variable success rates. We report a case of persistent post-surgical VVF successfully treated with image-guided embolization using n-butyl cyanoacrylate methylsulfone (NBCA; Glubran 2, GEM; Viareggio, Italy) through a transvesical catheter-based approach after failure of conservative management. This case illustrates the potential role of interventional radiology in the management of selected VVFs, suggesting that image-guided fistula embolization may represent a minimally invasive treatment option when conservative management fails and surgical reintervention is undesirable or can be deferred.