Early Diagnosis and Treatment of Vesicouterine Fistula Using Low-Tech Methods in Low Resource Setting of Northern Ghana. A Case Report

Vesicouterine fistula is a rare but increasing phenomenon in obstetric practice. Early diagnosis and treatment will go a long way to reduce the associated morbidity as well as improve the quality of life of its victims. Our case exemplifies how the use of simple techniques can diagnose and bring great relief to such patients.

Laparoscopic treatment of vesicouterine fistula (a literature review and case report)

Urogenital fistulas are common complication of obstetric and gynecological surgery; the most common are vesicovaginal fistulas. Vesicouterine fistulas are rare, which explains the difficulties in diagnosis and treatment. The literature review and own clinical case presented in article. A 43-years-old female patient was consulted with complaint of urinary leakage from vagina, which appeared 1 month after the cesarean section and vesicouterine fistula has been diagnosed. Successful laparoscopic treatment of vesicouterine fistula was performed at the Avicenna Medical Center after 3 months. The urethral catheter was removed 7 days after surgery. At control examination after 1, 3 and 6 months, ultrasound examination of the pelvic organs confirmed the consistency of the scar on the uterus. Urination remained free and painless, the patient did not notice urine leakage. This clinical observation shows the possibility of treating a vesicouterine fistula with a laparoscopic approach with a good result and the possibility of early rehabilitation.

Delayed presentation of postcaesarean section vesicouterine fistula repaired robotically

A premenopausal patient in her late forties presented with a 15-year history of urinary incontinence starting shortly after a caesarean section performed for her fourth delivery and more recently associated episodic light haematuria and passage of clots per vagina. The haematuria was intermittent over several months and associated with per-vaginal bleeding. She had symptomatic anaemia. Flexible cystoscopy and MRI showed a vesicouterine fistula. She underwent a robotic-assisted hysterectomy and multi-layered repair of the bladder with omental interposition. She remained in the hospital for 4 days, though recovered well and underwent catheter removal at 14 days following a normal cystogram. At 3 months, she was well with no incontinence or urinary symptoms. This case demonstrates the need for vigilance in assessing patients with persistent incontinence, particularly in the context of prior caesarean section. It highlights the feasibility of robotic surgery for correcting these defects in a society where minimally invasive surgery is becoming the norm, and cosmesis is a priority for patients.

Vesicouterine fistula – a rare delayed complication of cesarean section

A vesicouterine fistula is an abnormal pathway between the urinary bladder and the uterus. It is a rare urogynaecological fistula. In vesicouterine fistula, clinical presentations are cyclic haematuria (menouria), amenorrhoea, urinary continence which mimics Youssef’s syndrome. This case presents, a 37 year old multiparous woman with vesicouterine fistula which she developed 8 years after cesarean section. Diagnosis was confirmed by cystoscopy and fistula was repaired through trans abdominal surgery. She regained normal vaginal menses 4 months after surgery. J Bangladesh Coll Phys Surg 2020; 38(4): 209-212

Vesicouterine fistula: a case report

Vesicouterine fistula represents a rare urogenital fistula, accounting for approximately 1-4% of genitourinary fistulas. Iatrogenic reasons have been shown to be most common cause. Surgical excision is the mainstay of treatment. Less than 5% patients respond to conservative management. Authors report a case of successful conservative management of vesicouterine fistula.