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

Abstract

Urogenital fistulas are abnormal communications between the female genital and urinary tract; while such fistulas, which are the most commonly encountered, are located between the vagina and urinary bladder and are caused by the local extension of a tumoral process. Another frequently encountered cause is represented by the obstetric one, leading to the development of uterovesical fistulas. However, many questions regarding the diagnosis and management of uterovesical fistulas remain unanswered. Therefore, the aim of this article was to review the existent data so far, with special attention being focused on the pathogenic mechanisms leading to this complication, on the modalities of diagnosis, and on the possible therapeutic strategies. Therefore, according to the time of diagnosis, uterovesical fistulas can be classified as early fistulas, diagnosed in the first months postoperatively and late fistulas, diagnosed within several years from the initial surgical procedure. For early fistulas, a conservative therapeutic strategy can be taken in consideration, while in cases diagnosed after a longer period of time, a surgical approach should be taken into consideration. Meanwhile, although a surgical approach can cure most of the cases, attention should be given towards preventive strategies such as provision of quality obstetric care with improvements of surgical skills. Contents1. Introduction 2. Clinical presentation 3. Diagnosis 4. Classification 5. Management 6. Prognosis 7. Conclusions

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

“…The menstrual blood enters the bladder directly rather than building up in the uterus and applying pressure to open the isthmus for menstrual flow. 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 .…”

“…However, individuals with fistulas below the isthmus experience regular menstrual flow. 4,5 It is usually diagnosed by cystoscopy, a transvaginal ultrasound, or…”

Utero-Vesical Fistula Closure after 3 Weeks Treatment with Intravenous Mesenchymal Stem Cells Infusion: Case Report

“…Currently, its prevalence is higher due to the increase in cesarean sections [1,2]. UVF can have several etiologies: 1) Obstetric causes: prolonged labor, cesarean section/ hysterectomy, instrumental maneuver during childbirth, traditional practices, embryotomy in abortions and symphysiotomy, 2) non-obstetric causes: trauma (intercourse, sexual violence, accident and sexual mutilation); infections (tuberculous granulomatous and HIV); as well as: pelvic surgery, radiotherapy and tumors [1,3]. of methylene blue.…”

“…After a cesarean section or other pelvic intervention, prolonged bladder catheterization is used for 4 to 6 weeks in order to allow the injured area to heal [3]. If the fistula is already formed, tube therapy offers little chance of spontaneous closure and instead increases inflammation and the risk of infection [3]. Despite the fact that in many cases the fistulas are already formed, doctors rather choose conservative treatment over surgical treatment [3].…”

“…If the fistula is already formed, tube therapy offers little chance of spontaneous closure and instead increases inflammation and the risk of infection [3]. Despite the fact that in many cases the fistulas are already formed, doctors rather choose conservative treatment over surgical treatment [3]. The main reasons are the complications that may arise as a consequence of surgical repair (infections or urinary incontinence) and the complexity of the recovery process.…”