Youssef's Syndrome following Cesarean Section.

Ozer Birge,Mustafa Melih Erkan,Deniz Arslan,Ertugrul Gazi Ozbey,Ilkan Kayar

doi:10.1155/2015/605325

Ozer Birge, Mustafa Melih Erkan + Show 3 more

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https://doi.org/10.1155/2015/605325

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Abstract

Youssef's syndrome is characterized by cyclic hematuria (menouria), absence of vaginal bleeding (amenorrhea), and urinary incontinence due to vesicouterine fistula (VUF), the least common of the urogynecological fistulas. Youssef's syndrome has a variable clinical presentation. A vesicouterine fistula is an abnormal pathway between the bladder and the uterus. The most common cause is lower segment Cesarean section. Conservative treatment may be appropriate in some cases, but surgery is the definitive treatment. Vesicouterine fistula should be suspected in cases presenting with urinary incontinence even years after Cesarean section. Diagnostic tests as well as necessary appropriate surgery should be performed on cases with suspected vesicouterine fistula. We present a 40-year-old multiparous woman with vesicouterine fistula after primary Cesarean section; she presented with urinary incontinence, hematuria, and amenorrhea 1 year after the birth. Here, we discuss our case with the help of previously published studies found in the literature.

Highlights

A vesicouterine fistula is an abnormal pathway between the bladder and the uterus
The vast majority of vesicouterine fistulae are secondary to iatrogenic causes, the most common being lower segment Cesarean section [2]
We present a case with vesicouterine fistula after primary Cesarean section; the patient presented with urinary incontinence, hematuria, and amenorrhea 1 year after giving birth

Summary

Introduction

A vesicouterine fistula is an abnormal pathway between the bladder and the uterus. The first case was reported by Knipe and colleagues in 1908. The vast majority of vesicouterine fistulae are secondary to iatrogenic causes, the most common being lower segment Cesarean section [2]. Most of the cases present in a delayed fashion, from weeks to years after the inciting event [3]. In such cases, the diagnosis is mainly established by clinical detection of urine or dye passing through the external cervical os or by means of a hysterosalpingogram or micturating cystourethrogram, which will demonstrate the fistulous communication [3]. We present a case with vesicouterine fistula after primary Cesarean section; the patient presented with urinary incontinence, hematuria, and amenorrhea 1 year after giving birth

Case Presentation

Discussion

Conclusion

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