Abstract
Neobladder-vaginal fistula (NVF) is a rare complication after radical cystectomy with orthotopic neobladder, impacting patient quality of life. This case report describes successful transvaginal, multilayered closure of NVF in a 59-year-old woman with urinary incontinence post-surgery. Despite prior intraoperative repair, an 8mm fistula was detected and repaired transvaginally. A watertight test confirmed closure, and the patient remained continent at 22 months follow-up. NVF rates range from 3 to 6%, with risk factors including poor vaginal vascularity and intraoperative injury. This case supports transvaginal repair as an initial approach, with further research needed to refine NVF management strategies.