[Youssef syndrome]

Youssef's syndrome is a vesico-uterine fistula through the uterine isthmus, with periodic hematuria, or menouria, and an absence of vaginal bleeding or urinary leaks. The sphincteric mechanism of the uterine isthmus could explain this symptoms, quite unusual for a urogenital fistula. Diagnosis can be achieved by cystography and hysterography. Surgical closure of the fistula is the usual treatment, but uterus can be preserved if patient wishes further pregnancy.