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Vesicouterine fistula in pregnancy: a case report
Sari Kives1, Marie-France Delisle, G W Erle Mitchell
1Department of Obstetrics and Gynecology, Dalhousie University, Halifax, NS.
Journal of Obstetrics and Gynaecology Canada : JOGC = Journal D'Obstetrique Et Gynecologie Du Canada : JOGC
|July 14, 2004
Summary
Vesicouterine fistula, a rare complication after Cesarean delivery, can occur during pregnancy. Early diagnosis via cystoscopy and surgical repair post-delivery are crucial for managing this condition.
Area of Science:
- Reproductive Medicine
- Urogynecology
Background:
- Vesicouterine fistula is a rare but serious complication following Cesarean delivery.
- This case represents the third documented instance of a vesicouterine fistula diagnosed during pregnancy.
Observation:
- A 28-year-old woman with a history of Cesarean delivery presented with suspected preterm ruptured membranes at 23 weeks' gestation.
- She also reported a fluid-filled sac protruding from her introitus.
- Cystoscopy revealed amnion ballooning into the bladder, confirming the fistula.
Findings:
- The patient underwent a vaginal breech delivery at 24 weeks' gestation.
- A transabdominal surgical repair of the vesicouterine fistula was successfully performed two months postpartum.
Implications:
- Vesicouterine fistula should be considered in pregnant women with a history of Cesarean delivery presenting with urinary incontinence or recurrent UTIs.
- Pregnancy evaluation is typically limited to cystoscopy.
- Surgical repair is generally delayed until 2-3 months after delivery.