[Vesico-uterine fistulas. Analysis of 19 cases]

Over a 15 year period (1977-1992), the authors have collected 19 cases of vesico-uterine fistulas. These vesico-uterine fistulas rank in third place of genito-urinary fistulas and occur in young patients (mean age is 30 years). Obstetrical etiology is recognised in .95% of cases (cesarean section and dystocic delivery). Leak of urine is present in 95% of cases, and is isolated in 47% or associated with intermittent hematuria in 48%. Diagnosis of this affection is based upon clinical examination with methylene blue test. Communication between bladder and uterus is proved by the issue of methylene blue through the uterus cervix. This communication may be confirmed by opacification (urography and hysterography). Perfect continence is obtained by surgical treatment. Fertility of these patients is often affected.