Vesicouterine fistula (VUF) is a rare complication following caesarean sections, often presenting with the classic triad of Youssef syndrome (urinary incontinence with cyclic haematuria (menouria) and amenorrhoea) but sometimes without typical symptoms. We report a case of a woman in her early 30s who developed VUF after an emergency lower segment caesarean section, complicated by necrotising soft tissue infection (NSTI) of the left forearm. One week post-surgery, she presented with NSTI symptoms and haematuria, which were managed with broad-spectrum antibiotics and debridement. During her hospital stay, she experienced persistent urinary incontinence and burning micturition. Evaluation of these symptoms revealed acute intestinal obstruction, and a contrast CT indicated vesicouterine communication. Surgical exploration confirmed a perforated uterus with possible retained placental tissue, and a VUF. Subtotal hysterectomy and bladder repair were performed, and her recovery was smooth. This case underscores the importance of considering VUF in patients with post-caesarean urinary symptoms, despite its rarity.
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A complication of emergency caesarean section: delayed diagnosis of vesicouterine fistula with associated necrotising soft tissue infection and small bowel obstruction.
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February 2025
All India Institute of Medical Sciences, New Delhi, Delhi, India.
Vesicouterine fistula (VUF) is a rare complication following caesarean sections, often presenting with the classic triad of Youssef syndrome (urinary incontinence with cyclic haematuria (menouria) and amenorrhoea) but sometimes without typical symptoms. We report a case of a woman in her early 30s who developed VUF after an emergency lower segment caesarean section, complicated by necrotising soft tissue infection (NSTI) of the left forearm. One week post-surgery, she presented with NSTI symptoms and haematuria, which were managed with broad-spectrum antibiotics and debridement.
View Article and Find Full Text PDFIatrogenic Female Genitourinary Fistula in Uganda: Etiology, Twelve-Year Trends, and Risk Factors for Development Following Cesarean Section.
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Department of Obstetrics and Gynecology, Mbarara University of Science and Technology, Faculty of Medicine, Mbarara, Uganda.
Purpose: To describe the magnitude and trend of the iatrogenic genitourinary fistula in Uganda, and the risk factors for development following the Cesarean Section (CS).
Methods: A retrospective review of charts of women with a confirmed diagnosis of genitourinary fistula at four regional fistula repair sites in Uganda between 2010 and 2021 was conducted. A fistula was classified as iatrogenic if it was; ureteric, vesico-cervical, vesico-uterine, or vaginal vault fistula that followed an obstetric or gynecological surgery.
Use of omentum during robotic-assisted reconstructive urological surgery: a systematic review of the current literature.
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Department of Urology, University of Leipzig, Leipzig, Germany.
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Background: Placenta accreta spectrum disorders are associated with a high risk of maternal morbidity, particularly when surgery is performed under emergency conditions. This study aimed to investigate the incidence of emergency cesarean delivery in patients with a high probability of placenta accreta spectrum disorders on prenatal imaging and to compare the maternal and neonatal outcomes between patients requiring emergency cesarean delivery and those not requiring emergency cesarean delivery.
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Successful transvaginal repair of a vesicouterine fistula with delayed presentation.
BMJ Case Rep
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Obstetrics and Gynecology, Ballad Health, Greeneville, Tennessee, USA
A G4P4 woman in her 30s with a type II vesicouterine fistula, as defined by the Jozwik classification system, presented with symptoms of menouria, vaginal menses and urinary incontinence 8 years after caesarean delivery, the time of probable origination of the fistula tract. Transvaginal ultrasound identified a fistula tract communicating between the bladder and uterus, a rare finding that many years remote from caesarean delivery. Traditional surgical technique includes laparoscopic, abdominal and endoscopic methods of repair, sometimes using a transvesical approach.
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