Author(s): Mokrzycki ML, Hampton BS
BACKGROUND: Vesicouterine fistula is a rare complication most commonly associated with cesarean section. Though conservative management has been reported, surgical intervention is usually required to treat the condition.
CASE: A 32-year-old woman presented with urinary incontinence following a primary cesarean section; it was initially thought to be a vesicovaginal fistula. Careful evaluation and a high index of suspicion resulted in the correct diagnosis of a vesicouterine fistula. The patient was successfully treated with uterus-sparing surgery.
CONCLUSION: This case illustrates the importance of a comprehensive evaluation of all patients suspected of having a urogenital fistula. A thorough workup led to the correct diagnosis of vesicouterine fistula and allowed the surgeons to plan the appropriate operative strategy in managing the patient.