Lethal haemorrhage due to erosion of external iliac artery in a patient with ureterovaginal fistula following endometriosis surgery

Widschwendter, Peter; Janni, Wolfgang; Benckendorff, Julian; Gregorio, Nikolaus de

doi:10.1177/2284026519872868

Cited by 1 publication

(1 citation statement)

References 9 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Clinical manifestations of VVFs can vary, complicating prompt detection. The symptoms of complex fistulas may include cyclical hematuria (menstruation), amenorrhea, urinary leakage from the vagina with or without urinary incontinence, recurrent urinary tract infections accompanied by low-grade fever, secondary infertility, first-trimester miscarriages, cystitis, hematuria, and pruritus vulvae [ 3 , 4 , 8 , 9 , 10 ]. Various imaging procedures have proven useful in diagnosis.…”

Section: Discussionmentioning

confidence: 99%

Diagnostic and Therapeutic Challenges of Oligosymptomatic Vesicovaginal Fistula in the Complex Case of Endometriosis

Strojny,

Baran,

Wiejak

et al. 2024

Clinics and Practice

View full text Add to dashboard Cite

Endometriosis is a complex condition causing surgical challenges, sometimes leading to urogynecological complications, the diagnosis and treatment of which are not always obvious. We present a case of a 46-year-old woman with a history of severe endometriosis and adenomyosis who developed an oligosymptomatic vesicovaginal fistula (VVF) as a complication of surgery. The patient’s medical history included multiple surgeries for endometriosis, a cesarean section, and a laparoscopic hysterectomy. After the excision of the full-thickness infiltration of the urinary bladder, she experienced postoperative bowel obstruction treated by laparotomy. Subsequent urinary complications of bladder healing were eventually recognized as oligosymptomatic VVF. Symptoms of VVFs may vary, making a diagnosis challenging, especially when the lesion is narrow. Imaging techniques such as cystoscopy and cystography are helpful for diagnosis. The treatment options for VVFs range from surgical repair to conservative methods, like bladder catheterization, hormonal therapy, and platelet-rich plasma (PRP) injections, depending on the lesions’ size and location. In this case, the patient’s VVF was treated with PRP injections, a low-invasive method in urogynecology. PRP, known for its pleiotropic role, is increasingly used in medicine, including gynecology. The patient’s fistula closed after 6 weeks from the PRP session, highlighting the potential of this conservative treatment modality.

show abstract