Two Cases of Vesicouterine Fistula after Delivery in Women with Previous Cesarean Section.
- Author:
Suk Bae KIM
1
;
Young Eun YOUN
;
Mi Sun PARK
;
Ok Rang PARK
;
Hang Jin KIM
Author Information
1. Department of Obstetrics and Gynecology, Daegu Fatima Hospital, Daegu, Korea. obgybbl@hanafos.com
- Publication Type:Case Report
- Keywords:
Vesicouterine fistula;
Previous Cesarean section;
VBAC
- MeSH:
Amenorrhea;
Cesarean Section*;
Cesarean Section, Repeat;
Diagnosis;
Female;
Fistula*;
Hematuria;
Humans;
Infertility;
Postoperative Period;
Pregnancy;
Ultrasonography;
Urinary Bladder;
Urinary Incontinence;
Urinary Tract Infections;
Uterus;
Vacuum;
Vaginal Birth after Cesarean
- From:Korean Journal of Obstetrics and Gynecology
2006;49(9):1956-1961
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
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.
