[Youssef syndrome (vesico-uterine fistula): three case reports]

Area of Science:

• Urology
• Gynecology
• Surgical Pathology

Background:

• Youssef syndrome is a rare complication characterized by a fistula between the urinary tract and the reproductive organs.
• Cesarean section is identified as a primary etiological factor in the reported cases.

Observation:

• Three cases of Youssef syndrome were observed over a decade, all secondary to cesarean section.
• Diagnosis involved clinical findings in one case, intravenous urography in all, and retrograde cystography in two cases.
• One patient refused treatment, while two underwent surgical intervention.

Findings:

• Surgical treatment resulted in good clinical outcomes, with symptom resolution observed at a mean follow-up of fifteen months.
• Intravenous urography visualized the uterine cavity in one case, highlighting its utility and limitations.
• Retrograde cystography proved effective in diagnosing the fistula in cases where urography was inconclusive.

Implications:

• This case series underscores the importance of considering Youssef syndrome in patients with a history of cesarean section presenting with urinary or reproductive tract abnormalities.
• Accurate and timely diagnosis through a combination of imaging techniques is crucial for effective management.
• Surgical management appears to be an effective treatment modality for Youssef syndrome, leading to favorable patient outcomes.