Management of vesicouterine fistula following cesarean section

Sonographic Diagnosis of a Uterovesical Fistula

“…To our knowledge, only about 30 cases have been reported, and other background information has also been published in the literature. [6][7][8][9] Our case followed difficult delivery by forceps. The patient had no urinary incontinence.…”

Uterovesical fistulas as obstetric complications: Diagnosis, management and prognosis (Review)

“…Most cases can be easily diagnosed during clinical examination and anamnesis; however, in order to confirm the diagnosis and to identify the site and trajectory of the fistulous path, imagistic studies are needed. Therefore, information obtained during standard clinical examination should be completed with those obtained during pelvic examination under anesthesia, cystourethrography, intravenous pyelography, sonohysterosalpingography, cystourethroscopy or hysteroscopy (3,23). However, in certain cases presenting long evolution of the disease, fistulous trajectory might be difficult to be demonstrated during such imagistic studies and therefore pelvic magnetic resonance imaging (MRI) might be needed (24).…”

“…During the same intervention, explorative cystoscopy can be also associated in order to confirm the presence of the second orifice of the fistulous trajectory at the level of the urinary bladder; meanwhile the distance between the fistulous orifice, the ureteral ostiums and urethra can be further evaluated. These aspects play a crucial role in regard with the future surgical management of the case (21)(22)(23)(24)(25).…”

“…Meanwhile, according to the time of diagnosis, they can be considered as early or late complications. Therefore, fistulas diagnosed in the first months after an obstetric procedure are considered to be early fistulas and are expected to be successfully managed in a conservative manner while fistulas reported after a later period of time (years) are considered late fistulas and usually necessitate a complex surgical procedure in order to be assessed (21)(22)(23)25).…”