Colouterine Fistula Treated by a Double Endoscopic Approach

Colouterine fistula associated with the use of an intrauterine device (IUD) is extremely rare. Clinical presentation may vary; however, to our knowledge, only 1 paper has previously reported menochezia as the main symptom of an utero-intestinal fistula as a complication of IUD use. Surgery is generally needed for definitive resolution of the fistula. Various surgical approaches have been proposed, mainly using open approaches owing to the presence of severe pelvic adhesions. Reports of laparoscopic treatment have been rarely described. We performed a successful conservative double endoscopic repair, with hysteroscopy followed by laparoscopy. Follow-up of IUD users is important, as complications may appear at any time. Unusual signs or symptoms warrant attention. Imaging tests aid in diagnosis and treatment selection, which in the majority of cases means planning for surgery. An endoscopic approached is preferred because of its lower risk of complications and shorter postoperative recovery period.