Vesicocervical Fistula Post Emergency Repeat Caesarean Delivery

Urogenital fistula is an abnormal communication between the urinary tract and genital tract at different levels, vesicocervical fistula being rare. It has been the consequence of poor obstetric care in developing world and iatrogenic following gynecologic surgeries in developed world. Diagnosis is mainly done by clinical examination, conventional dye test with methylene blue and imaging studies and cystoscopy, if required. Though prevention is better than cure, early detection followed by transurethral bladder drainage and surgical correction via vaginal or abdominal approach is the mainstay of treatment. A 30 years postnatal mother was referred to our centre with complaints of continuous involuntary leakage of urine per vaginum following emergency repeat caesarean delivery done six weeks back. There was pooling of urine over Sim’s speculum and dye test was positive. Under spinal anesthesia, vesicocervical fistula was repaired vaginally and patient was kept on Foley’s catheter for three weeks. Dye test performed at the end was negative. She went home dry and continent. We present here a rare case of successful repair of vesicocervial fistula post emergency repeat caesarean delivery.

Vesicocervical fistula following vesicovaginal fistula repair report

Vesicocervical fistula following vesicovaginal fistula repair is a very rare condition. It is a complication following repeated lower uterine cesarean section. We report a case of an young married woman who was admitted in the depart­ment of urology, Banghabandhu Sheikh Mujib Medical University Hospital with vesico-cervical fistula following vesico­vaginal fistula repair. Reposition of cervix into vaginal vault and repair of urinary bladder was done. There was no such report of vesicocervical fistula following vesicovaginal fistula repair from Bangladesh.

A Case of Vesicocervical Fistula

J Dhaka Medical College, Vol. 21, No. 2, October, 2012, Page 226-228 DOI: http://dx.doi.org/10.3329/jdmc.v21i2.15363