Conservative management of vesico-vaginal fistula after uterine and partial bladder necrosis due to embolization as a treatment for postpartum hemorrhage

Acute Bladder Necrosis after Pelvic Arterial Embolization for Pelvic Trauma: Lessons Learned from Two Cases of Immediate Postembolization Bladder Necrosis

“…The bladder vascular supply derives from the anterior trunk of the internal iliac artery, which gives way to the superior and inferior vesical arteries. Prior literature has discussed known sequelae and has identified injuries to the bladder resulting in necrosis of bladder tissue due to decreased perfusion from these vessels [ 2 , 4 , 5 , 7 , 8 ]. A retrospective study by Matityahu et al examined complications after pelvic angiographic embolization.…”

Bladder Necrosis Associated with Placenta Accreta, Embolization, and Repair of Cystotomies

“…They also report this patient had necrosis at the bladder dome. 1 She developed a vesicovaginal fistula following conservative management of her bladder necrosis, which was surgically corrected. Pisco and colleagues also reported on a male patient with bladder ischemia with desquamation of bladder mucosa following angioembolization of prostatic arteries in a series of 250 patients available for follow-up.…”

Current opinion: postpartum urinary disorders

“…Thin lower uterine segments in conjunction with bladder adhesive disease and poor visualization of the vesicouterine flexure are likely the cause behind these rare fistulas [34]. Lastly, a handful of case reports have also highlighted genitourinary fistulas in the setting of uterine artery embolization for postpartum hemorrhage [35]. While all of these scenarios are rare, genitourinary fistulas must be considered if patients present with atypical symptoms such as continuous clear vaginal leakage.…”