Live fetus inside the urinary bladder: a case report

Abstract

Vesicouterine fistula is a rare condition. Its incidence, however, has been increasing due to the higher incidence of cesarean sections. The presence of a live fetus inside the bladder who passed through a vesicouterine fistula is an extremely rare situation. We report a case of woman who underwent two previous cesarean sections, was referred to a hospital due to mild pelvic pain and genital bleeding. At the moment, physical examination was normal. Ultrasound scan revealed a gestational sac inserted into the anterior wall of the uterus, with a living fetus of approximately 13 weeks, with active body movement and normal heart rate inside it. The fetal abdomen, around the waist, was stuck at the opening of a vesicouterine fistula, so that the fetal head and trunk were entirely into the bladder cavity, while lower limbs remained at the uterine cavity. Laparotomy was performed, the fistulous tract was excised, the fetus (without heart beating) was removed on opening the bladder, and the uterine cavity was emptied. The defects in the bladder and uterus were repaired. The postoperative period was uneventful. A live fetus inside the urinary bladder is a rare condition the continuation of pregnancy is unlikely and the vesicouterine correction can be made by the time of surgical intervention.

Vesical ectopic pregnancy due to vesicouterine fistula: A case report with literature review

“…magnetic resonance imaging, to name a few important modalities. 6 Vesical ectopic pregnancy is an extremely unusual condition; only four cases were recorded before the present case.…”

“…Ectopic pregnancies can occur in various locations, including the fallopian tube, cervix, ovary, corneal region of the uterus, and abdominal cavity. 1,6 Although rare, there have been a few reported cases of the bladder being a possible site. 2 A fistula can occur between the urinary bladder and the uterine cavity or cervical canal and also between the uterine cavity or cervical canal and the abdominal wall.…”

“…Ectopic pregnancies can occur in various locations, including the fallopian tube, cervix, ovary, corneal region of the uterus, and abdominal cavity 1,6 . Although rare, there have been a few reported cases of the bladder being a possible site 2 .…”

“…However, individuals with fistulas below the isthmus experience regular menstrual flow 4,5 . It is usually diagnosed by cystoscopy, a transvaginal ultrasound, or magnetic resonance imaging, to name a few important modalities 6 . Vesical ectopic pregnancy is an extremely unusual condition; only four cases were recorded before the present case.…”

“…These factors could potentially be risk factors for ectopic pregnancy. 6 The earliest case documented in the literature was reported by DelRosario and El-Roeiy 12 in 1996 and involved a patient who had had cancer and metastasis, with a history of in vitro fertilization, which could be the underlying risk factors for her condition. 12 Unlike our case, no history of previous cesarean sections was recorded in this particular instance.…”