Colouterine fistula after polymyomectomy: a case report

Uzan, Jennifer; Koskas, Martin; Fournier, Pierre; Margulies, Anne Laure; Luton, Dominique; Yazbeck, Chadi

doi:10.1186/1752-1947-8-199

Cited by 6 publications

(6 citation statements)

References 15 publications

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“… 26 Unfortunately, myomectomy is associated with surgical risks and complications (most importantly, blood loss requiring transfusion, long procedures and hospital stays, postoperative morbidity, and even life-threatening complications). 27 Postoperative adhesions are of particular concern because their presence increases the risk of impaired spontaneous fertility. Avoiding laparotomy in young patients is most likely beneficial in terms of fertility, and the use of UPA could be an interesting alternative.…”

Section: Discussionmentioning

confidence: 99%

Clinical utility of ulipristal acetate for the treatment of uterine fibroids: current evidence

Bourdet

Luton

Koskas

2015

IJWH

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Uterine myoma is the most common benign uterine tumor in women of reproductive age and occurs in 20%–25% of the worldwide population. No currently approved medical treatment is able to completely eliminate fibroids. Surgery, particularly hysterectomy, predominates as the treatment strategy of choice, even though it is associated with risks and complications and causes infertility. Until recently, gonadotropin-releasing hormone agonists were the only available drugs for the preoperative treatment of fibroids. However, ulipristal acetate (UPA), an oral selective progesterone receptor modulator, was recently licensed in Europe for the same indication. Recent studies have demonstrated the efficacy and safety of UPA in the medical management of fibroids before surgery, with a better tolerability profile than leuprolide acetate. Analyzing the literature, we identified new management strategies involving UPA and surgery, considering advantages of both medical and surgical therapy. The advent of UPA will undoubtedly modify the surgical approach to fibroids, but the heterogeneity of these possible indications now requires various original clinical studies to identify the optimal indications for UPA in patients with symptomatic fibroid(s).

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Section: Discussionmentioning

confidence: 99%

Clinical utility of ulipristal acetate for the treatment of uterine fibroids: current evidence

Bourdet

Luton

Koskas

2015

IJWH

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“…Colouterine fistula is very rare condition with only around 25 reported cases of post-diverticulitis colouterine fistula so far. [ 1 2 3 4 5 6 ] Other causes include sigmoid malignancy, radiotherapy, and iatrogenic conditions such as insertion of intrauterine devices, endometrial curettage with uterine, and bowel perforation, or obstetrical injury.…”

Section: Introductionmentioning

confidence: 99%

Different etiologies of an unusual disease: Colouterine fistula – Report of two cases

Aggarwal

Indiran

Maduraimuthu

2018

Indian Journal of Radiology and Imaging

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Colouterine fistula is an extremely rare condition, as the uterus is a thick, muscular organ. Here, we present two different etiologies for this rare condition—diverticulitis and malignancy. A 77-year-old female with colouterine fistula due to diverticulitis presented with complaints of lower abdominal pain localized particularly in the left iliac fossa and fever. Another case was of 73-year-old female with colouterine fistula due to malignancy who presented with abdominal pain, blood in stools, and whitish discharge from vagina. Both cases were evaluated with contrast-enhanced computed tomography (CECT). The presence of air and fluid within the uterus on ultrasound or CT scan, prompts the possibility of colouterine fistula with CECT providing accurate preoperative assessment.

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“…Frequently, the patient will undergo a segmental colectomy, with or without stoma formation and abdominal hysterectomy, to deal with the uterine defect resulting from the fistula. There has been only one single attempt in the literature, of laparoscopic treatment resulting in an en bloc sigmoid colectomy and hysterectomy,11 while an organ-sparing treatment option keeping the uterus has only been reported in two other cases 8 10…”

Section: Discussionmentioning

confidence: 99%

Single-incision laparoscopic (SIL) sigmoid colectomy and uterus-preserving repair for colo-uterine fistula secondary to severe diverticular disease: an unusual technical solution for an unusual presentation of a common disease

et al. 2016

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Colouterine fistula as a potential complication of chronic diverticulitis is a rare entity with less than 30 cases reported worldwide. Generally, patients require a multidisciplinary approach including a major laparotomy with hysterectomy and sigmoid colectomy, and, occasionally, temporary colostomy. We report the first attempt of a novel, minimally invasive technique for managing a case of benign colouterine fistula with single-incision laparoscopic (SIL) sigmoid colectomy and uterus preservation. A small, 3 cm incision site provided access for the whole operation, as well as played a role as the specimen extraction site. Malignant fistulas and large uterine defects may require hysterectomy, however, laparoscopic closure of uterine wall defects can be considered as a reasonable alternative in selected patients, avoiding the higher risks associated with hysterectomy and keeping fertility at younger ages. Single incision laparoscopy in complicated diverticular disease and fistula formation cases is a challenging but technically feasible option, in experienced hands.

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Colouterine fistula after polymyomectomy: a case report

Cited by 6 publications

References 15 publications

Clinical utility of ulipristal acetate for the treatment of uterine fibroids: current evidence

Clinical utility of ulipristal acetate for the treatment of uterine fibroids: current evidence

Different etiologies of an unusual disease: Colouterine fistula – Report of two cases

Single-incision laparoscopic (SIL) sigmoid colectomy and uterus-preserving repair for colo-uterine fistula secondary to severe diverticular disease: an unusual technical solution for an unusual presentation of a common disease

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