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Vesicouterine Fistula and Fetus in Bladder: A Case Report
Heather Armstrong1, Paul Thistle2
1Department of Obstetrics and Gynaecology, Faculty of Medicine, University of British Columbia, Vancouver, BC.
Background:
Vesicouterine fistulas are the rarest of all urogenital fistulas, with most cases occurring after cesarean section.
Case:
A 38-year-old woman in rural Zimbabwe presented at 20 weeks gestation with a suspected fetus in the urinary bladder by transabdominal ultrasonography. This finding was confirmed intraoperatively together with a vesicouterine fistula. Cesarean section 20 years earlier was the only risk factor. Diagnosis was delayed for lack of access to appropriate imaging and a tertiary facility.
Conclusion:
A vesicouterine fistula is a rare presentation in the context of an advanced health care system. To our knowledge, this is the fourth case report of a fetus in the bladder secondary to vesicouterine fistula. Patient morbidity in this case possibly could have been avoided with earlier diagnosis and access to care.
