[Vesico-uterine fistula after delivery: a case report]

A case of vesico-uterine fistula which occurred after natural childbirth is reported. A 33-year-old woman was admitted in February, 1993, complaining of urinary leakage from vagina immediately after natural childbirth. Excretory urogram showed an oval shaped extravasation outside the bladder, suggesting that the contrast medium went into the luminal space of the uterus. Subsequent cystoscopy showed a fistula on the posterior wall, probably the orifice of the fistula to the space. As these findings strongly suggested the vesico-uterine fistula, surgical operation was done. Rupture of the uterus was observed. Then hysterectomy was done because the rupture could not be repaired. Vesico-uterine fistula was thought to be the result of the rupture of uterus. Bladder side fistula was successfully repaired. Sixty eight cases of vesico-uterine fistula, including this case, in the Japanese literature have been reviewed and discussed the etiology, symptom and treatment.