Endoscopic fulguration versus surgical repair of vesico-uterine fistula

Although surgical correction of vesico-uterine fistulae gives good results, endoscopic fulguration is a new trend for treatment of these cases. These two modalities were compared. Six cases of vesico- uterine fistula caused by bladder injury at cesarean section [4 cases] and by rupture uterus and bladder after obstructed labor [2 cases]. Three cases were treated by endoscopic fulguration, after 6 months follow up, 2 cases have been small and just admitting the 6 ch. fulguration electrode, but the third case showed vaginal leakage immediately after removal of the urethral catheter 6 weeks after fulguration, this case had a giant fistula. Three cases were treated abdominally via transabdominal transperitoneal route and omental flap. All these cases were completely cured. Treatment of small vesico- uterine fistula by endoscopic fulguration is recommended, because of its simplicity and low morbidity. However, large fistulae are preferably treated surgically