Vesicovaginal Fistula Formation After Cervical Cerclage Mimicking Premature Rupture of Membranes

Wall, L. Lewis; Khan, Fareesa; Adams, Stephanie J.

doi:10.1097/01.aog.0000247291.00155.88

Cited by 12 publications

(10 citation statements)

References 10 publications

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“…Two VVFs occurred after cervical cerclage, as previously described in the literature. 21 The risk of this procedure is usually underestimated, and deep or high placement of the cervical suture should, therefore, be avoided. Furthermore, vaginal leakage after cervical cerclage should not be assumed to be the rupture of membranes and must be thoroughly investigated to rule out urogenital fistula.…”

Section: Discussionmentioning

confidence: 99%

Causes and management of urogenital fistulas

Osman

Al‐Badr

Malabarey

et al. 2018

SMJ

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Objectives:To review the etiology and management of urogenital fistulas at a tertiary care referral center.Methods:We retrospectively identified all patients with urogenital fistula referred to the King Fahad Medical City, Riyadh, Saudi Arabia, between January 2005 and July 2016 from electronic records. We collected data on age, parity, etiology and type of fistula, radiologic findings, management, and outcome.Results:Of the 32 patients with urogenital fistula identified, 17 (53.1%) had vesicovaginal fistula. The mean parity was 5.9 (0-15). Obstetric surgery was the most common etiology, accounting for 22 fistulas (68.8%). Twenty of these (90.9%) were complications of cesarean delivery, of which 16 (80%) were repeat cesarean delivery. Forty surgical repair procedures were performed: 20 (50%) via an abdominal approach, 11 (27.5%) via a vaginal approach, 7 (17.5) via a robotic approach, and 2 (5%) using cystoscopic fulguratizon. The primary surgical repair was successful in 23 patients (74%), the second repair in 5 (16.1%), and the third repair in one (3.1%). One fistula was cured after bladder catheterization, and 2 patients are awaiting their third repair.Conclusion:Unlike the etiology of urogenital fistulas in other countries, most fistulas referred to our unit followed repeat cesarean delivery: none were caused by obstructed labor, and only a few occurred after hysterectomy. Most patients were cured after the primary surgical repair.

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Section: Discussionmentioning

confidence: 99%

Causes and management of urogenital fistulas

Osman

Al‐Badr

Malabarey

et al. 2018

SMJ

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“…1,14 It remains unclear whether dissection of the vesicovaginal space may be protective against inadvertent suture placement into or through the bladder wall, but cystoscopy after the cerclage placement may be beneficial to identify stitch placements that involve the bladder.…”

Section: Discussionmentioning

confidence: 99%

“…1,2 There are multiple complications of cerclage reported in the literature with most occurring in the antepartum or intrapartum periods. 3 Remote sequelae and genitourinary injury because of cerclage placement are rare.…”

mentioning

confidence: 99%

Commonalities of Cerclage-Related Genitourinary Fistulas

Massengill¹,

Baker²,

Pechmann³

et al. 2012

Female Pelvic Medicine &Amp; Reconstructive Surgery

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“…Vesicovaginal fistulas are usually related to gynecologic surgery, most commonly hysterectomy in developed countries 5 . Recently, some cases have reported that vaginal foreign body 11,12 or cervical cerclage 13 cause vesicovaginal fistulas. Most authors who reported these cases suggest chronic irritation and inflammation, not direct penetration, would cause the complication.…”

Section: Discussionmentioning

confidence: 99%

Vesicovaginal fistula following large‐loop excision of the transformation zone in a chronic systemic glucocorticoid user

Park¹,

Ku²,

Kim³

et al. 2011

J of Obstet and Gynaecol

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A 42-year-old woman with a history of a large-loop excision of transformation zone for cervical intraepithelial neoplasia III four years previously visited our outpatient department for cervical intraepithelial neoplasia I that newly detected by colposcopy-directed punch biopsy. Her other medical conditions include systemic lupus erythematosus on daily prednisolone 15 mg during 19 years. After second large-loop excision of transformation zone, delayed vesicovaginal fistula was confirmed by indigo carmine leakage test, computed tomography scan, and cystoscopy. Fistula was primarily repaired with indwelling double-J catheters with anchoring omentum on suture site.

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Vesicovaginal Fistula Formation After Cervical Cerclage Mimicking Premature Rupture of Membranes

Abstract: Obstetricians should recognize that cerclage placement may result in unusual urinary tract injury.

Cited by 12 publications

References 10 publications

Causes and management of urogenital fistulas

Causes and management of urogenital fistulas

Commonalities of Cerclage-Related Genitourinary Fistulas

Vesicovaginal fistula following large‐loop excision of the transformation zone in a chronic systemic glucocorticoid user

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