Fetal limb in bladder: A rare complication of vesicouterine fistula

Vesicouterine fistula (VUF) is a rare urogenital fistula that is even rarer during pregnancy. Even if pregnancy occurs, the outcomes appear to be very poor. The most of the cases are related to iatrogenic bladder injury during cesarean section. There is very limited literature on the pregnancy with VUF associated with herniation of fetus or fetal part(s) into the bladder cavity. Here, we report a case of pregnancy in a known case of untreated VUF. She presented at 23 weeks of gestation with features of premature rupture of membrane and herniation of fetal left lower limb inside the bladder cavity. Her pregnancy ended up with hysterotomy and the removal of a non-viable fetus along with the repair of the fistula. Hence, regardless of the severity of the signs and symptoms associated with VUF, clinicians should convince the patients for the repair of the fistula especially if the future pregnancy is contemplated

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.

Diagnosis and treatment of uterine fistula after cesarean section / 中国实用妇科与产科杂志

Uterine fistula after cesarean section mainly occurs in developing countries.With the development of social economy,the incidence of uterine fistula in China is gradually decreasing.However,in recent years,the incidence of placenta previa–accreta is increasing and the intraoperative injury is increasing.We describe the most common uterine fistula after cesarean section to provide reference and basis for its diagnosis and treatment.

Fístula vesicouterina con dos trayectos fistulosos: reporte de un caso

Se comunica el caso de una fístula vesicouterina en una paciente de 39 años que había sido sometida a segunda cesárea segmentaria. Se realizó el cierre del trayecto fistuloso vesicocervical vía vaginal, presentando secreción mucosa vaginal a la tercera semana. La histerosonografía mostró pasaje de contraste del istmo a la vejiga. Vía abdominal, se individualizó útero de vejiga, se extrajo el trayecto fistuloso a nivel del istmo uterino y se cerró en dos planos. El resultado después de la segunda intervención fue satisfactorio. En el seguimiento hasta 24 meses después de la cirugía, la paciente estaba asintomática.

A case of vesicouterine fistula in a 39 year-old woman who had been subjected to second segmental cesarean section is reported. The fistulous tract was repaired vaginally, but vaginal mucous secretion appeared on the third week. Hysterosonography showed contrast medium passage from isthmus to bladder. By laparotomy the uterus was individualized from the bladder, the fistulous tract was removed at the uterine isthmus and closed in two layers. Result after the second surgical intervention was satisfactory. The patient was asymptomatic 24 months post surgery.

Vesicouterine Fistula Following Repeated Cesarean Section / 대한비뇨기과학회지

Vesicouterine fistula is a rare disease that comprises 1 to 4% of all reported urogenital fistulas. Repeated cesarean section may be related to the formation of vesicouterine fistula. We experienced a case of vesicouterine fistula, and the patient's symptom was gross hematuria during her mensturation period after repeated cesarean section.

Two Cases of Vesicouterine Fistula after Delivery in Women with Previous Cesarean Section / 대한산부인과학회지

Vesicouterine fistula, a fistula between bladder and uterus, is one of the rarest urogenital fistula. Most cases are associated with repeat Cesarean section and with vaginal birth after Cesarean section (VBAC). During Cesarean section, it is important to dissect and move the bladder away from uterus carefully, especially in case of adherent bladder to the anterior vaginal wall or lower segment wall and it is necessary to explain the possibility of vesicouterine fistula development in case of VBAC. Patients usually present with urinary incontinence in the early postoperative period or present months or years later with cyclic hematuria, amenorrhea, vaginal leakage of urine, urinary tract infection and secondary infertility. The diagnosis is made by cystoscopic visualization of the fistula orifice in the bladder and outlining the fistula tract on cystogram, hysterosalpingogram or transvaginal ultrasonogram. There have been varied approaches to the treatment of vesicouterine fistula with conservative therapy or surgical therapy. We experienced two cases of vesicouterine fistulas in women with previous Cesarean section, the one is delivered with repeat Cesarean section after trying VBAC, the other is delivered with vacuum assisted VBAC, and treated with surgical repair.

Laparoscopic Management of Vesicouterine Fistula due to Intrauterine Device / 대한비뇨기과학회지

We report the vesicouterine fistula due to migration of intrauterine device in 35-year-old woman, who had suffered from dysuria and watery vaginal discharge for 4 months. The vesicouterine fistula was confirmed by ultrasonography, cystoscopy and fistulography, and treated with laparoscopic fistulectomy.

Vesicouterine Fistula: A Report of Two Cases / 대한비뇨기과학회지

Vesicouterine fistula is a rare condition, and almost of them result from surgical obstetric procedures. We have experienced two cases of vesicouterine fistulas, one of which developed menouria. Herein these two cases of vesicouterine fistulas have been presented. Case 1; A 29_year_old housewife had underwent dilatation and curettage at local clinic. Afterwards she has been noticed urinary leakage from the vagina and menturia. Cystoscopic examination revealed a small fistula at midportion of the retrotrigone and hysterosalpingography showed a fistula between the bladder and the uterus. Transperitoneal closure of the fistula was performed with excellent result. Case 2; A 32-year-old housewife had. gross hematuria after bugination and curettage for interruption of midtrimester pregnancy and noticed urinary leakage from the vagina a few days later. A fistula between the bladder and the uterus was identified with cystoscopic examination, cystography and hysterosalpingography. A 24 Fr. silastic Foley catheter has been indwelt in the bladder for 4 weeks, but resulted in failure. Transperitoneal closure of the fistula resulted in cure.