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Concurrent vesicoperitoneal and vesicovaginal fistulae
Rebecca James1, Sangeeta Tina Mahajan
1MacDonald Women's Hospital, University Hospitals Case Medical Center, Cleveland, OH, USA. Rebecca.James@uhhospitals.org
International Urogynecology Journal
|December 7, 2011
Summary
Vesicovaginal and vesicoperitoneal fistulae are rare postoperative complications. Conservative management with bladder drainage led to successful recovery in a patient presenting with abdominal pain and anuria.
Area of Science:
- Urology
- Gynecologic Surgery
Background:
- Vesicovaginal fistulae (VVFs) and vesicoperitoneal fistulae (VPFs) are uncommon but challenging postoperative complications.
- These fistulae often arise after gynecologic procedures, including hysterectomy.
Observation:
- A patient developed both VVF and VPF after a laparoscopic-assisted vaginal hysterectomy.
- The patient presented with significant abdominal pain and anuria, indicative of a severe complication.
Findings:
- Diagnostic cystogram and cystoscopy were crucial for identifying the complex fistulae.
- Conservative management, specifically continuous bladder drainage via an indwelling catheter, proved effective.
Implications:
- This case highlights the importance of diagnostic tools like cystography and cystoscopy in managing rare fistulae.
- Conservative management can be a successful approach, potentially avoiding surgical intervention for complex vesicovaginal and vesicoperitoneal fistulae.
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