Laparoscopic Repair of Uteroperitoneal Fistula

An unexpected connection: getting to know uteroperitoneal fistulas

“…Similar to other uterine fistulas, the recommended mode of delivery after uteroperitoneal fistula repair should be via cesarean section to reduce the risk of uterine rupture or fistula recurrence. Successful previous live births after repair have been reported (1). Although rare, uteroperitoneal fistula repair through a minimally invasive approach with techniques demonstrated in this video can allow for an improvement of symptoms and presumed fertility.…”

“…Uteroperitoneal fistulas are anomalous connections between the uterus and peritoneal cavity usually resulting from gynecologic surgery or other pathology that leads to ischemia and poor healing. The true incidence is unknown as they are extremely rare with just over 15 cases reported in the medical literature (1). Most frequently, these fistulas are seen anteriorly after cesarean delivery due to inadequate healing but have also been reported with surgical termination of pregnancy, myomectomy, and salpingectomy.…”

“…Once identified, surgical repair remains the primary treatment option for uteroperitoneal fistulas. In the limited reported cases in the literature, most patients received fertility-sparing surgery with excision and repair of the fistula defect, while two underwent hysterectomy (1). Both women who underwent hysterectomy were multiparous with one case noted to have extensive erosion of the uterine wall not amendable to repair.…”