Abstract
Introduction and Aim of the Study: Vesicouterine fistula (VUF) is the rarest form of genitourinary fistulas, being in most cases secondary to a previous cesarean section. Amenorrhea and menstrual bladder hemorrhage or menouria are the most common symptoms.
Surgical treatment consists of, classically, a transperitoneal approach with interposition of material. Despite the advantages of laparoscopy, there are few cases which report its feasibility in the management of this entity. We aimed to review the management of a VUF (Youssef’s syndrome) with a laparoscopic approach.
Case and Results: We present the surgical technique with a laparoscopic approach for repairing a VUF using primary closure of the fistula and TachoSil® interposition.
A 40-year-old woman was referred to our department with urinary incontinence associated with menouria, 2 months following an abortion at 22 weeks of pregnancy. The cystoscopy showed the findings of a well-granulated fistulous in the posterior wall of the bladder, and the computerized tomography (CT) showed the presence of VUF that connected the base of the bladder and the anterior uterine wall. The woman, otherwise healthy, had previously had six pregnancies, and her first child was born by caesarean section. After the birth of the fourth child, she presented vesicovaginal fistula that was managed with a bladder catheter satisfactorily.
With the diagnosis of VUF, a laparoscopic repair was underwent with no complications in the operative and early postoperative period. She has remained asymptomatic with the resumption of normal menses and no clinical evidence of fistula recurrence at 3 months follow-up. Four months after surgery, the patient got pregnant again. At 37 weeks of pregnancy, a planned cesarean section was performed. No fistula recurrence at 22 months of follow-up.
Conclusion: Laparoscopic repair of a VUF is a feasible, effective, and safe technique with a successful outcome.
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References
Abdel-Karim A, Elmissiry M, Moussa A, Mahfouz W, Abulfotooh A, Dawood W, Elsalmy S. Laparoscopic repair of female genitourinary fistulae: 10-year single-center experience. Int Urogynecol J. 2020;31(7):1357–62.
Naouar S, Braiek S, El Kamel R. Laparoscopic repair of vesicouterine fistula: a case report and mini-review of the literature. J Curr Surg. 2016;6(3–4):75–7.
Garza Cortés R, Clavijo R, Sotelo R. Laparoscopic treatment of genitourinary fistulae. Arch Esp Urol. 2012;65(7):659–72.
Knipe WHW. Vesico-uterine fistula. Am J Obstet Gynecol. 1908;57:211–7.
Alonso M, Broseta E, y Jiménez, J. Cap 130: Fístulas urogenitales. In: Jiménez J, Rioja LA, editors. Tratado de Urología. 2nd ed. Barcelona: Prous SA; 2006. p. 2537–59.
Youssef AF. Menouria following lower segment cesarean section; a syndrome. Am J Obstet Gynecol. 1957;73(4):759–67.
Ghoniem GM, Warda HA. The management of genitourinary fistula in the third millennium. Arab J Urol. 2014;12(2):97–105.
Unger CA, Cohen SL, Einarsson JI, Morse AN. Laparoscopic repair of vesicouterine fistula. Female Pelvic Med Reconstr Surg. 2012;18(3):190–2.
Bonillo García MA, Pacheco Bru JJ, Palmero Martí JL, Alapont Alacreu JM, Alonso Gorrea M, Arlandis Guzmán S, Jiménez Cruz JF. Fístulas vesicouterinas. Nuestra experiencia tras 25 años [Vesicouterine fistula. Our experience of 25 years]. Actas Urol Esp. 2003;27(9):707–12.
Symeonidis EN, Sdralis E, Symeonidis A, Georgiadis C, Kalyvas V, Malioris A, Papathanasiou M. Vesicouterine Fistula (VUF) as a rare urogenital complication managed with delayed surgical repair: a case report and review of the literature. Case Rep Obstet Gynecol. 2018;2018:2394896.
Hadzi-Djokic JB, Pejcic TP, Colovic VC. Vesico-uterine fistula: report of 14 cases. BJU Int. 2007;100(6):1361–3.
Chibber PJ, Shah HN, Jain P. Laparoscopic O’Conor’s repair for vesico-vaginal and vesico-uterine fistulae. BJU Int. 2005;96(1):183–6.
Das Mahapatra P, Bhattacharyya P. Laparoscopic intraperitoneal repair of high-up urinary bladder fistula: a review of 12 cases. Int Urogynecol J Pelvic Floor Dysfunct. 2007;18(6):635–9.
Maioli RA, Macedo AR, Garcia AR, Almeida SH, Rodrigues MA. Laparoscopic repair for vesicouterine fistulae. Int Braz J Urol. 2015;41(5):1030–1.
Melon J, Chao F, Chan W, Rosamilia A. Video of the laparoscopic repair of a vesico-uterine fistula. Int Urogynecol J. 2018;29(4):599–600.
Miklos JR. Laparoscopic treatment of vesicouterine fistula. J Am Assoc Gynecol Laparosc. 1999;6(3):339–41.
Purkait B, Mehrotra S, Sinha RJ, Bhaskar V, Singh V. Long-term outcome of laparoscopic vesicouterine fistula repair: experience from a tertiary referral centre. Turk J Urol. 2017;43(4):512–6.
Hemal AK, Kumar R, Nabi G. Post-cesarean cervicovesical fistula: technique of laparoscopic repair. J Urol. 2001;165(4):1167–8.
Rao MP, Dwivedi US, Datta B, Vyas N, Nandy PR, Trivedi S, et al. Post caesarean vesicouterine fistulae—Youssef syndrome: our experience and review of published work. ANZ J Surg. 2006;76(4):243–5.
Lotocki W, Jóźwik M, Jóźwik M. Prognosis of fertility after surgical closure of vesicouterine fistula. Eur J Obstet Gynecol Reprod Biol. 1996;64(1):87–90.
Singh V, Mandhani PA, Mehrotra S, Sinha RJ. Laparoscopic repair of vesicouterine fistula: a brief report with review of literature. Urol J. 2011;8(2):149–52.
Chang-Jackson SC, Acholonu UC Jr, Nezhat FR. Robotic-assisted laparoscopic repair of a vesicouterine fistula. JSLS. 2011;15(3):339–42.
Martinez Escoriza JC, Palacios Marques AM, Lopez Fernandez JA, Feliu Rey E, Martin Medina P, Herraiz Romero I, et al. Congenital vesicovaginal fistula with or without menouria: a literature review. Eur J Obstet Gynecol Reprod Biol. 2014;175:38–48.
Mercader VP, McGuckin JF Jr, Caroline DF, Chatwani A, Seidmon EJ. CT of vesicocorporeal fistula with menouria: a complication of uterine biopsy. J Comput Assist Tomogr. 1995;19(2):324–6.
Lenkovsky Z, Pode D, Shapiro A, Caine M. Vesicouterine fistula: a rare complication of cesarean section. J Urol. 1988;139(1):123–5.
Martius H. Die operative Wiederherstellung der vollkommen fehlenden Harnrohre und des Schiessmuskels derselbel. Zentralbl Gynakol. 1928;52:480–6.
Giusti G, Lucci Chiarissi M, Abate D, De Vita G, Angioni S, De Lisa A. Early repair of post-hysterectomy vesicovaginal fistulae through a laparoscopic transperitoneal extravesical approach. Experience of a single center. Urology. 2018;119:44–8.
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Arrébola-Pajares, A. et al. (2022). Vesicouterine Fistula. In: Dökmeci, F., Rizk, D.E.E. (eds) Insights Into Incontinence and the Pelvic Floor. Springer, Cham. https://doi.org/10.1007/978-3-030-94174-1_5
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