Vesicouterine Fistula Research Articles

Vesicouterine fistulae as complications of repeated cesarean section

In all, only 167 cases of vesicouterine fistula have been documented in the world medical literature to date. In this paper the authors report five cases observed during the last 10 years, all secondary to cesarean section. It was the second operation for 3 patients and the third for the other 2. Two patients had urinary incontinence and 3 had amenorrhea and cyclic hematuria. The authors confirm the importance of conducting adequate investigations to ensure proper diagnosis of the fistula, and describe the choice of surgical approach.

Recognition and management of patients with high-risk vesicovaginal fistulas: Implications for teaching and research

Vesicovaginal fistulas (VVFs) occurring as a result of obstetric trauma are a vast problem in Nigeria and Ghana, where at least 20 000 women await repair, and fewer than 50 physicians have the necessary expertise. Through a series of conferences those VVFs that are at high risk and those at low-risk for repair failure, were identified. A clinic was established where repair of low-risk VVFs was done on an ongoing basis in a remote region of Ghana. A visiting surgical team was utilized to repair the difficult, or high-risk, VVFs, which included 4–6 cm VVFs (3), recurrent VVF (1), combined VVF and RVF (rectovaginal fistula), a large 5 cm juxtacervical VVF (1), and a vesicouterine fistula (1). Management of these patients and others with VVF repair complications is discussed.

Youssef’s Syndrome: An Appraisal of Hormonal Treatment

Two cases of vesicouterine fistula, caused by lower-segment cesarean section, are presented. Both cases had classical symptoms of Youssef's syndrome, i.e. cyclic hematuria, absence of vaginal bleeding and complete urinary continence. These patients were treated by the continuous administration of an estrogen-progestogen combination for 6 months. However, it failed in 1 case requiring transabdominal transperitoneal closure of the fistula with an interposition of omentum. We feel that hormonal treatment may be tried as first modality in the treatment of Youssef's syndrome, before resorting to surgery.

Transvaginal repair of vesicocervical fistulae ? A forgotten method by Volkovich-K�stner?

The vaginal approach to vesicocervical fistulae by N. Volkovich [1] and O. Kustner [2] was characterized by the use of an artificial uterine descensus to achieve collapse and cushioning of the bladder defect. Over the past 35 years, this principle has been applied to 22 vesicouterine fistulae on 12 occasions. The technique is described in detail. Separation of the fistular canal is today followed by closure of the tract in both the bladder and the cervix. Sometimes, interposition of peritoneum was added (n=6). The method was primarily suitable for uncomplicated vesicocervical fistulae (n=4) or for vesicocervicovaginal fistulae (n=8) with the uterine corpus still present and to be preserved. However, if subtotal hysterectomy had been performed before (n=6), transvaginal extirpation of the remaining cervix and a bladder repair would be necessary. On the other hand, vagino-abdominal hysterectomy and bladder repair were unavoidable in cases of vesicocervicocorporeal fistulae (n=3) and in 1 case of vesicocervicovaginal fistula with a severely distorted cervix. Therapy was successful in all cases.

Actinomycotic Vesico‐uterine Fistula from a Wishbone Pessary Contraceptive Device

Presented is the case of a 77-year-old British women with sudden onset of vaginal bleeding and a 3-year history of urinary incontinence. A wishbone-type pessary, inserted in 1945 and never removed, was found to be the source of these symptoms. Cystoscopy revealed a large fistula at the bladder base, and bacterial culture of the pyometra grew bacteroides and actinomyces. The symptoms abated after closure of the fistula and antibiotic treatment. This is the first report of a vesico-uterine fistula due to a wishbone pessary. In the other similar case reported in the literature, a vesico-uterine fistula was related to a Maslin Spring IUD that had been inserted 14 years prior to presentation. The IUD is an ideal predisposing factor for the development of pelvic actinomycosis.

Management of vesico-uterine fistulae: a report of six cases

Six cases of vesico-uterine fistulae caused by cesarean section in four and pelvic trauma in two cases were treated during the past 15 years. Both the cases of vesico-uterine fistulae due to pelvic trauma and one case of vesico-uterine fistula due to cesarean section in whom the fistula was detected in the early post-operative period, could be managed successfully by suprapubic urinary diversion and control of infection. Two patients who were seen more than 1 year after the cesarean section, were cured by trans-abdominal closure of the fistula with omental interposition. One patient who reported 3 months after the cesarean section was managed by estrogen and progesterone-induced amenorrhea. The management protocol for vesico-uterine fistula should thus be individualised taking into consideration the etiology, and time interval between its occurrence and institution of treatment regimen.

Vesico-uterine fistula.

Nine cases of vesico-uterine fistula caused by injury to the bladder at Caesarean section or by rupture of the uterus and bladder following obstructed labour are described. Symptoms depend on the level of the lesion, menstruation into the bladder and menouria occurring when the fistula is above the internal cervical os: whatever the level, most patients with vesico-uterine fistula present with incontinence of urine. A transperitoneal approach appears to give better results than a transvesical repair.

Management of vesicouterine fistula following cesarean section

Contrary to belief, urinary incontinence in vesicouterine fistulas following cesarean section is as common as cyclic hematuria with apparent amenorrhea. Review of the English literature revealed 21 cases and herein is added a new case. The presentations and management of such cases are discussed.

Acquired Obstetric and Gynecologic Urinary Fistulas

ABSTRACT Sixty female patients with acquired urinary fistulas are reviewed. These include ureterovaginal, urethrovaginal, vesicovaginal, and vesicouterine fistulas; many patients had more than one ...

VESICO‐UTERINE FISTULA TREATED BY AMENORRHOEA INDUCED WITH CONTRACEPTIVE STEROIDS. TWO CASE REPORTS

Two women with vesico-uterine fistulae causing amenorrhoea and cyclic hematuria were successfully treated by the continuous administration of an oestrogen-progestogen combination for six months.

Spontaneous Closure of Vesicouterine Fistula after Cesarean Section

Abstract An unusual case of spontaneous healing of a vesicouterine fistula after cesarean section is reported.

Spontaneous Closure of Vesicouterine Fistula after Cesarean Section

Abstract An unusual case of spontaneous healing of a vesicouterine fistula after cesarean section is reported.

Vesicouterine Fistula with Menouria - A Case Report

Vesicouterine fistula is a very rare urogenital fistula but may be iatrogenic, following a Caesarean section operation. Presentation and position of fistulas make their diagnoses very difficult. Hysteroscopy, cystoscopy, hysterosalphingography, Computed Tomography scan and Magnetic Resonance Imaging are very useful to diagnose the condition precisely. History of the patient, clinical examination and instillation of methylene blue into the uterine cavity through cervix or through the urethra are an option to diagnose vesicouterine fistula in a low resource centre. Key words: Vesicouterine fistula; Menouria; Caesarean section. DOI: 10.3329/jdmc.v19i2.7088J Dhaka Med Coll. 2010; 19(2) : 150-153

Urological Injuries Following Obstetric and Gynecological Surgeries

Obstetric and gynecological surgeries are not uncommon cause of iatrogenic injury to the urinary tract. In this study, we retrospectively report our experiences with these injuries over the last 8 years. Between January-2000 and December-2008, 80 female with age range of 21 to 65 years, presented to us with various urological injuries following obstetric or gynecological surgeries. The types of injury were as follows: vesico-vaginal fistula (56), uretero-vaginal fistula (14), unilateral ureteral ligation (5), bilateral ureteral ligation (2), ureteral trans-section (2), and vesico-uterine fistula (1). In this series, all patients of urological injuries due to obstetric or gynecological surgery were cured of their complications and were free of any complain related to the procedures, except 3 cases of VVF who experienced a failed initial repair. They were managed successfully by 2nd surgery. Injury may occur during obstetric and gynecological surgeries to the urinary tract. This iatrogenic injury imposes a great impact on physical and mental conditions of the patient and her family. Therefore, it is mandatory for the gynecologists and obstetricians to pay careful attention to the anatomy of the urinary tract in order to avoid such iatrogenic injuries. doi: 10.3329/taj.v21i2.3793 TAJ 2008; 21(2): 135-139

VESICO-UTERINE FISTULA.

SUMMARYA case of vesicouterine fistula following on Caesarean section is described. The case is briefly discussed and the literature reviewed.

Spontaneous Closure of Vesicouterine Fistula Following Cesarean Section

A VESICOUTERINE FISTULA may be defined as an abnormal communication between the bladder and uterine cavity above the level of the cervical internal os, which allows the menstrual blood to enter the bladder and causes cyclic hematuria. Normal menstruation and leakage of urine from the vagina are usually absent. Figure 1 demonstrates the anatomy of this type of fistula as compared with the other more common genitourinary fistulas. Only 8 cases of vesicouterine fistula have been described in the world literature to date, probably because this condition is almost always a complication of the lower-segment type of cesarean section which has been popular in only the past 25 years. This is the first case report of a vesicouterine fistula that closed spontaneously. Report of a Case A 25-year-old, primigravid, clinic patient was admitted to the Lenox Hill Hospital labor ward on Nov. 21, 1958, at term and in early labor.

“Menouria” following lower segment cesarean section: A syndrome

1.1. A peculiar syndrome which may follow lower segment cesarean section is characterized by the presence of a vesicouterine fistula above the level of the internal os, the occurrence of vesical menstruation, the absence of vaginal menstrual periods, and the absence of urinary incontinence although the cervical canal is patent.2.2. The name “menouria” has been coined to describe the vesical menstruation which is always the chief presenting symptom.3.3. The few cases showing these typical features that have so far been reported in the literature are reviewed and a case of my own is described in detail.4.4. Thorough investigation of my case has revealed that all the interesting features of this syndrome can be explained by the presence of a functional sphincter at the uterine isthmus.5.5. The causes of the great racity of the syndrome are discussed.6.6. A plea is made that every case of this nature should be thoroughly investigated and reported.

Vesicouterine Fistula Associated with a Calcified Leiomyoma: Case Report

Vesicouterine Fistula Associated with a Calcified Leiomyoma: Case Report

Sigmoidouterine and vesicouterine fistula as a complication of childbirth

Sigmoidouterine and vesicouterine fistula as a complication of childbirth

Spontaneous closure of large vesico-uterine fistula: Brodhead, George L.: Medical Record, 1920, xcviii, 437

Spontaneous closure of large vesico-uterine fistula: Brodhead, George L.: Medical Record, 1920, xcviii, 437