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Updated: Feb 18, 2026
Vessel-sparing Excision and Primary Anastomosis
Published on: January 7, 2019
Repair of a vesicouterine fistula following cesarean section
Rodolfo Milani1, Alice Cola1, Matteo Frigerio1
1Department of Obstetrics and Gynaecology, San Gerardo Hospital, University of Milano-Bicocca, Via Pergolesi 33, Monza, MB, Italy.
Introduction And Hypothesis:
Vesicouterine fistula is a rare complication of cesarean section. The aim of this video is to present a case report and to provide a tutorial on the surgical technique of delayed transvaginal repair of a high vesicouterine fistula that developed after cesarean section with manual removal of a morbidly adherent placenta.
Methods:
A 43-year-old woman was referred to our unit for continuous urinary leakage 3 months after undergoing a cesarean section with manual removal of a morbidly adherent placenta. A vesicouterine fistula starting from the posterior bladder wall was identified. The surgical repair consisted of a transvaginal layered repair as shown in the video.
Results:
No surgical complications were observed postoperatively. Two months after surgery the fistula had not recurred and the patient reported no urinary leakage.
Conclusions:
Transvaginal layered primary repair of vesicouterine fistula was shown to be a safe and effective procedure for restoring continence. The vaginal route can be particularly attractive for urogynecological surgeons.
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