Utero-Vesical fistulas are the rarest of all urogenital fistulas, with most cases occurring after cesarean section. Its prevalence is increasing worldwide because of the increasing indications of cesarean section. Patient usually presents with urine leak, amenorrhea and cyclic hematuria. Herein, we present a case of patient presenting with complain of severe urinary tract infection following cesarean section. Review and update of recent literature regarding the diagnostic imaging of this entity are described.

Background/Aims  During the peak of COVID-19 pandemic, there were growing concerns that rheumatology patients could have an increased risk of contracting coronavirus due to the immunosuppressive drugs that they were taking. British Society for Rheumatology (BSR) recommended in its risk stratification guide in March 2020 that vulnerable patients should be either shielded or isolated according to their level of risk. The purpose of this survey is to evaluate the compliance to the risk stratification advice among rheumatology patients in a single centre. Methods  Risk stratification guidance was sent out to 401 patients recommending either to shield or to isolate. Patients were contacted over the telephone between 14 September and 18 October 2020 to ensure they had received a postal letter with risk stratification advice. If received, it was checked whether they had followed the guidance. Responses received from all participants were analysed. Results  93% (373) of patients confirmed that they had received the guidance; however, 8 patients suggested they hadn’t received and we were unable to contact 16 patients, despite trying multiple times. Four patients died but they did not have confirmed coronavirus. 267 confirmed they were shielding and 83 were isolating, but 21 patients decided not to follow the guidance despite the recommendation and two patients stopped taking the drugs due to fear of contracting the coronavirus. Total 258 females and 143 males with the mean age 59. Most common diagnoses were rheumatoid arthritis (227), psoriatic arthritis (97) and axial spondyloarthritis (59). It was noted that out of 7 patients who had symptoms suggestive of COVID-19, only three patients were confirmed to have COVID-19 positive PCR test. Three most commonly used drugs were Benepali (128) followed by Amjevita (100), then Rituximab (56). Conclusion  Although uptake of postal communication was high in this study, it was difficult to establish how rapidly the guidance was delivered. We realise the need to employ better ways of communicating with the patients. Innovative ways such as text messaging and social media have an important role in the delivery of a rapid mass communication during the pandemic. It was reassuring to note that only a very small number of patients had COVID-19 among the patients who followed the government advice to either shield or isolate. But, it would be interesting to see whether the incidence of COVID-19 cases rise since rheumatology patients are no longer shielding. Disclosure  S. Azam: None. E. Thompson: None. N. Costello: None. A. Ahmed: None. A. Nune: None. H. Ahmed: None.