Delayed presentation of postcaesarean section vesicouterine fistula repaired robotically

Area of Science:

• Urology
• Gynecology
• Minimally Invasive Surgery

Background:

• Urinary incontinence and hematuria can arise after cesarean delivery.
• Vesicouterine fistulas are rare but serious complications.
• Persistent symptoms necessitate thorough diagnostic evaluation.

Observation:

• A patient with a 15-year history of urinary incontinence and recent hematuria post-cesarean section presented with symptomatic anemia.
• Flexible cystoscopy and MRI confirmed a vesicouterine fistula.
• The patient experienced intermittent hematuria and vaginal bleeding.

Findings:

• Robotic-assisted hysterectomy and multi-layered bladder repair with omental interposition were performed.
• The patient recovered well with no urinary symptoms at 3-month follow-up.
• Successful surgical correction of the vesicouterine fistula was achieved.

Implications:

• Vigilant assessment of persistent incontinence, especially after cesarean section, is crucial.
• Robotic surgery offers a feasible and effective minimally invasive option for complex pelvic floor defects.
• This case underscores the importance of advanced surgical techniques in improving patient outcomes and prioritizing cosmesis.