Skip to main content

Advertisement

SpringerLink
Log in

Vesicouterine fistulae: our experience of 17 cases and literature review

  • Original Article
  • Published:
International Urogynecology Journal Aims and scope Submit manuscript

Abstract

Aim

A retrospective study of vesicouterine fistulae managed from 1996 to 2011 analyzed the incidence, symptomatology, diagnosis, and surgical outcome.

Patients & methods

During the study period, 17 patients were managed, of whom 14 underwent abdominal repair and three underwent vaginal repair. Mean patient age was 31.1 years and mean follow-up 7.3 years.

Results

Vesicouterine fistulae resulted following cesarean section in 13 patients and vaginal delivery in four. Eleven patients presented with urinary leakage via the vagina and seven with menouria. All patients had successful outcomes irrespective of treatment approach. The uterus was conserved in ten patients, of whom seven had completed their childbearing. The remaining three conceived spontaneously and underwent elective cesarean section.

Conclusion

The majority of vesicouterine fistulae occur following cesarean section, and it is feasible to achieve 100 % successful repair. Though the majority require abdominal repair, a few selected cases can be successfully repaired vaginally.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Hadzi-Djokic JB, Pejcie TP, Colovic VC (2007) Vesico-uterine fistula: report of 14 cases. BJU Int 53:1361–1363

    Article  Google Scholar 

  2. El-Lamie I (2008) Urogenital fistulae: changing trends and personal experience of 46 cases. Int Urogynecol J Pelvic Floor Dysfunct 19:267–272

    Article  PubMed  Google Scholar 

  3. Porcaro AB, Zicari M, Zecchini Antoniolli S et al (2002) Vesicouterine fistulas following cesarean section: report on a case, review, and update of the literature. Int Urol Nephrol 34:335–344

    Article  PubMed  Google Scholar 

  4. Jozwik M, Jozwik M, Lotocki W (1998) Vesicouterine fistula–an analysis of 24 cases from Poland. Int J Gynaecol Obstet 57:169–72

    Google Scholar 

  5. Youssef AF. Menouria following lower segment Cesarean section. A syndrome. Am J Obstet Gynecol 1957: 759–767.

  6. Jozwik M, Jozwik M (1999) Spontaneous closure of vesicouterine fistula: account for effective hormonal treatment. Urol Int 62:183–7

    Article  PubMed  CAS  Google Scholar 

  7. Rubins A (1926) Labour complicated by utero-vesical fistula. Br Med J 1:97

    Article  Google Scholar 

  8. Knipe WHW (1908) Vesico-uterine fistula. Am J Obstet 57:211–217

    Google Scholar 

  9. Kirchner WCG (1933) Sigmoido uterine and vesicouterine fistula as a complication of childbirth. Am J Obstet Gynecol 25:241–251

    Google Scholar 

  10. Tancer ML (1986) Vesicouterine fistula-a review. Obstet Gynecol Surv 41:743–753

    Article  PubMed  CAS  Google Scholar 

  11. Buckspan MB, Simha S, Klotz PG (1983) Vesicouterine fistula: a rare complication of cesarean section. Obstet Gynecol 62:64S

    PubMed  CAS  Google Scholar 

  12. Holden D, Vere M, Manyonda I (1994) Vesico-uterine istula occurring in a woman with a previous cesarean section and two subsequent normal vaginal deliveries. Br J Obstet Gynaecol 101:354–356

    Article  PubMed  CAS  Google Scholar 

  13. Miklos JR, Sze E, Parobeck D, Karram MM (1995) Vesicouterine fistula: a rare complication of vaginal birth after cesarean. Obstet Gynecol 86:638–639

    Article  PubMed  CAS  Google Scholar 

  14. Antonio Setubal, Clode N, Bruno-Paiva JL, Roncon I, Graca LM (1999) Vesicouterine fistula after manual removal of placenta in a woman with previous cesarean section. Eur J Obstet Gynecol Reprod Biol 84:75–76

    Article  Google Scholar 

  15. Alkatib M, Franco AV, Fynes MM (2005) Vesicouterine fistula following cesarean delivery–ultrasound diagnosis and surgical management. Ultrasound Obstet Gynecol 26:183–185

    Article  PubMed  CAS  Google Scholar 

  16. Sefrioui O, Benabbes Taarji H, Azyez M, et al. Vesico-uterine fistula of obstetrical origin. Report of 3 cases [article in French] Ann Urol (Paris). 2002;36:376–80.

    Article  CAS  Google Scholar 

  17. Kilhl B, Nilson AE, Pettersson S (1980) Postcesarean vesico-uterine fistula. Acta Obstet Gynecol Scand 59:277–280

    Article  Google Scholar 

  18. Hemal AK, Wadhwa SN, Kriplani A, Hemal U (1994) Youseef’s syndrome: an appraisal of hormonal treatment. Urol Int 52:55–57

    Article  PubMed  CAS  Google Scholar 

  19. DiMarco CS, DiMarco DS, Klingele CJ et al (2006) Vesicouterine fistula: a review of eight cases. Int Urogynecol J Pelvic Floor Dysfunct 17:395–9

    Article  PubMed  Google Scholar 

  20. Park BK, Kim SH, Cho JY, Sim JS, Seong CK (1999) Vesicouterine fistula after cesarean section: ultrasonographic findings in two cases. J Ultrasound Med 18:441–3

    PubMed  CAS  Google Scholar 

  21. Mercader VP, McGuckin JF Jr, Caroline DF, Chatwani A, Seidmon EJ (1995) CT of vesicocorporeal fistula with menouria: a complication of uterine biopsy. J Comput Assist Tomogr 19:324–6

    Article  PubMed  CAS  Google Scholar 

  22. Smayra T, Ghossain MA, Buy JN, Moukarzel M, Jacob D, Truc JB (2005) Vesicouterine fistulas: imaging findings in three cases. Am J Roentgenol 184:139–42

    Google Scholar 

  23. Yip SK, Leung TY (1998) Vesicouterine fistula: un updated review. Int Urogynecol J 9:252–256

    Article  CAS  Google Scholar 

  24. Bettez M, Breault G, Carr L, Tu LM (2011) Early versus delayed repair of vesicouterine fistula. Can Urol Assoc J 5(4):E52–E55

    Article  PubMed  Google Scholar 

  25. Shanmugasundaram R, Gopalakrishnan G, Nitin S, Kekre NS (2008) Youssef's syndrome: is there a better way to diagnose? Indian J Urol 24(2):269–270

    Article  PubMed  CAS  Google Scholar 

  26. Huang SC, Yao BL, Chou CY (1996) Transvaginal ultrasonographic findings in vesico-uterine fistula. J Clin Ultrasound 24:209–212

    Article  PubMed  CAS  Google Scholar 

  27. Tostain J (1992) Youssef syndrome [in French]. Acta Urol Belg 60:35–41

    PubMed  CAS  Google Scholar 

  28. Tarhan F, Erbay E, Penbegul N et al (2007) Minimal invasive treatment of vesicouterine fistula: a case report. Int Urol Nephrol 39:791–3

    Article  PubMed  Google Scholar 

  29. Graziotti P, Lembo A, Artibani W (1978) Spontaneous closure of vesicouterine fistula after cesarean section. J Urol 120:372

    PubMed  CAS  Google Scholar 

  30. al-Rifaei M, el-Salmy S, al-Rifaei A, Salama A (1996) Vesicouterine fistula: variable clinical presentation. Scand J Urol Nephrol 30:287–289

    Article  PubMed  CAS  Google Scholar 

  31. Jozwik M, Jozwik M, Sulkowska M, Musiatowicz B, Sulkowski S (2004) The presence of sex hormone receptors in the vesicouterine fistula. Gynecol Endocrinol 18:37–40

    Article  PubMed  CAS  Google Scholar 

  32. Rubino SM (1980) Vesico-uterine fistula treated by amenorrhoea induced with contraceptive steroids: two case reports. Br J Obstet Gynaecol 87:343–344

    Article  PubMed  CAS  Google Scholar 

  33. Yokoyama M, Arisawa C (2006) Masao ando successful management of vesicouterine fistula by luteinizing hormone-releasing hormone analog. Int J Urol 13:457–459

    Article  PubMed  Google Scholar 

  34. Tancer ML (1992) Observations on prevention and management of vesicovaginal fistula after total hysterectomy. Surg Gynecol Obstet 175:501–506

    PubMed  CAS  Google Scholar 

  35. Tanaka K, Chokyu H, Yoshimura K, Umezu K, Yasuno H (1996) Vesicouterine fistula - a case report. Hinyokika Kiyo Acta Urol Japan 42:601–603

    CAS  Google Scholar 

  36. Molina LR, Lynne CM, Politano VA (1989) Treatment of vesicouterine fistula by fulguration. J Urol 141:1422–3

    PubMed  CAS  Google Scholar 

  37. Falk HC, Tancer ML (1956) Management of vesical fistulas after cesarean section. Am J Obst Gynecol 71:97–106

    CAS  Google Scholar 

  38. Willson-Pepper JK (1965) Vesico-uterine fistula. Brit J Urol 37:433–436

    Article  PubMed  CAS  Google Scholar 

  39. Chibber PJ, Shah HN, Jain P (2005) Laparoscopic O’Conor’s repair for vesico-vaginal and vesico-uterine fistulae. BJU Int 96:183–6

    Article  PubMed  Google Scholar 

  40. Das Mahapatra P, Bhattacharyya P (2007) Laparoscopic intraperitoneal repair of high-up urinary bladder fistula: a review of 12 cases. Int Urogynecol J Pelvic Floor Dysfunct 18:635–639

    Article  PubMed  Google Scholar 

  41. Ramalingam M, Senthil K, Pai M, Renukadevi R (2008) Laparoscopic repair of vesicouterine fistula-a case report. Int Urogynecol J Pelvic Floor Dysfunct 19:731–3

    Article  PubMed  Google Scholar 

  42. Hemal AK, Kumar R, Nabi G (2001) Post-cesarean cervicovesical fistula: technique of laparoscopic repair. J Urol 165(4):1167–8

    Article  PubMed  CAS  Google Scholar 

  43. Benchekroun A, Lachkar A, Soumana A, Farih MH, Belahnech Z, Marzouk M, Faik M (1999) Vesico-uterine fistulas. Report of 30 cases. Ann Urol (Paris) 33:75–79

    CAS  Google Scholar 

  44. Allenby K, Rand RJ (1996) Pregnancies in woman with vesicouterine fistula following lower segment caesarean section. Br J Obstet Gynaecol 103:87–89

    Article  PubMed  CAS  Google Scholar 

  45. Dubllison JB, Barbol J, Santarelli J (1979) Vesico-uterine fistula after caesarean operation. J Gynecol Obstet Biol Reprod 9:229–233

    Google Scholar 

  46. Lotocki W, Jozwik M, Jozwik M (1996) Prognosis of fertility after surgical closure of vesicouterine fistula. Eur J Obstet Gynecol Reprod Biol 64:87–90

    Article  PubMed  CAS  Google Scholar 

  47. Singh V, Mandhani PA, Mehrotra S, Sinha RJ (2011) Laparoscopic Repair of Vesicouterine Fistula :A Brief Report With Review of Literature. Urol J 8(2):149–152

    PubMed  Google Scholar 

Download references

Conflicts of interest

None.

Author information

Authors and Affiliations

  1. Department of Urogynaecology, Government Kasturba Gandhi Hospital & Institute of Social Obstetrics, Madras Medical College, Trilplicane, Chennai, Pin 600005, India

    N. Rajamaheswari & Archana Bharti Chhikara

  2. House No. 1398, Sector 15, Sonepat, Haryana, Pin 131001, India

    Archana Bharti Chhikara

Authors
  1. N. Rajamaheswari
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Archana Bharti Chhikara
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Archana Bharti Chhikara.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Rajamaheswari, N., Chhikara, A.B. Vesicouterine fistulae: our experience of 17 cases and literature review. Int Urogynecol J 24, 275–279 (2013). https://doi.org/10.1007/s00192-012-1798-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00192-012-1798-8

Keywords

Search

Navigation