Laparoscopic Management of Post-Cesarean Section Uterocutaneous Fistula

Shah, Nitin; Changede, Pradnya; More, Vibha

doi:10.1007/s13224-018-1197-2

Cited by 11 publications

(9 citation statements)

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“…2 Pathogenesis of UCF is multifactorial but initial iatrogenic disruption of the integrity of the uterine wall, subcutaneous tissue, and skin, further compounded by subsequent infective necrosis are likely contributory factors. Typical pelvic surgical procedures associated with UCF include CS 1,2 and open myomectomy 7,9 as in both of these, a potential channel is created between the uterus and the abdominal skin. The mechanism of action of leuprolide in this case is unclear but we postulate that it produces endometrial atrophy, leading to contracture, fibrosis, and eventual closure of the fistulous tract.…”

Section: Discussionmentioning

confidence: 99%

“…In this case, we have used high resolution MRI as an alternative method of definitive diagnosis. 2 Pathogenesis of UCF is multifactorial but initial iatrogenic disruption of the integrity of the uterine wall, subcutaneous tissue, and skin, further compounded by subsequent infective necrosis are likely contributory factors. Typical pelvic surgical procedures associated with UCF include CS 1,2 and open myomectomy 7,9 as in both of these, a potential channel is created between the uterus and the abdominal skin.…”

Section: Discussionmentioning

confidence: 99%

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Medical management of small uterocutaneous fistulae with gonadotrophin releasing hormone analogs: Case report and literature review

Carles

Sharif

Arias

et al. 2022

J of Obstet and Gynaecol

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Conventional management of uterocutaneous fistula involves open or laparoscopic excision as well as hysterectomy but there is now increasing recognition of successful medical treatment with gonadotrophin releasing hormone agonists. We describe the fourth case in the literature of successful nonsurgical treatment of uterocutaneous fistula and discuss two important factors affect the success of medical management, namely the size of the fistula and the duration of treatment. We would recommend that a trial of gonadotrophin releasing hormone analogues for at least 6 months particularly in cases of uterocutaneous fistula of 5 mm or less in diameter as this conservative treatment is likely to obviate the need for more hazardous surgical intervention.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Medical management of small uterocutaneous fistulae with gonadotrophin releasing hormone analogs: Case report and literature review

Carles

Sharif

Arias

et al. 2022

J of Obstet and Gynaecol

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“…Additionally, postoperative infection, multiple abdominal surgeries, incomplete closure of the uterine wound, endometriosis, 1,2 and tuberculosis are possible contributing factors. 3,4 Most reported cases were diagnosed after cesarean section complicated by postoperative infection. [5][6][7][8][9] Myomectomy is a common operation for symptomatic women with uterine fibroids who wish to preserve their reproductive potential, and to date, only three cases of uterocutaneous fistula have been reported after myomectomy.…”

Section: Discussionmentioning

confidence: 99%

“…With developments in minimally invasive surgery, laparoscopic surgery or combined laparoscopic surgery and laparotomy have achieved successful clinical outcomes. 4,8,12 Most reported cases of uterocutaneous fistula were associated with postoperative infection, and patients had dense adhesions between the uterus and adjacent organs. Therefore, attention should be paid to concurrent bladder and bowel injury.…”

Section: Discussionmentioning

confidence: 99%

Uterocutaneous fistula after abdominal myomectomy: A case report

Wang

Shu

Shi

et al. 2021

J of Obstet and Gynaecol

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Uterocutaneous fistula is an extremely rare postoperative complication and the most appropriate treatment remains unclear. In this case report, we described uterocutaneous fistula of a 41-year-old woman with persistent purulent discharge from a small opening in her midline incision after abdominal myomectomy. The patient was diagnosed as uterocutaneous fistula based on magnetic resonance imaging and the methylene blue dye test. Fertility-sparing surgery was performed and uterocutaneous fistula was successfully corrected. Some nonabsorbable silk sutures were found attached to the sinus tract. This could lead to infection, which could cause the formation of a uterocutaneous fistula. Since after 1-year of operation, no evidence of recurrence was found. Fertility-sparing surgery is effective for a patient with uterocutaneous fistula. Complete resection of the sinus tract and surrounding necrotic tissue is required in the repair of urterocutaneous fistula.

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“…Previous reports pointed out the laparotomic surgical excision of the fistula tract as the treatment of choice [ 7 ]. Only a few reports in the literature describe successful laparoscopic surgical management of the uterocutaneous fistula [ 24 , 25 ], although evidence clearly shows the superiority of the minimally invasive surgery routes in terms of safety and efficacy in the case of benign gynaecological pathologies [ 26 ]. In this case, we opted for a liquid penetrant examination procedure: after preparation of the operating table, positioning of a Foley catheter, disinfection of the skin, and delimitation of the operating field with sterile sheets, a Pfannenstiel incision was performed on the scar from a previous caesarean section.…”

Section: Case Presentationmentioning

confidence: 99%

Utero-cutaneous fistula after caesarean section delivery: diagnosis and management of a rare complication

Etrusco¹,

Fabio²,

Cucinella³

et al. 2022

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Utero-cutaneous fistula is an extremely rare condition characterized by an abnormal communication between the anterior wall of the uterus and the abdominal wall. The causes include multiple caesarean sections, incomplete hysterorrhaphy, miscarriages, uterine cavity revision, retention of placental material after delivery, use of drains, post-operative infections, or injuries.Herein, we report a case of a 38-year-old female, who underwent caesarean section 42 days earlier and presented to the emergency room complaining of fever, abdominal pain, and purulent discharge from the abdominal wall from 6 days. Her medical history included 2 previous term caesarean section deliveries and an hysteroscopic polypectomy 2 years earlier. A pelvic computed tomography scan with contrast medium showed fluid/super-fluid phlogistic collection reported at the anterior wall of the uterus with a continuous solution of the uterine wall itself. Magnetic resonance imaging demonstrated the presence of a probable hyperintense fistula, extended for 30 mm and 16 mm of thickness, which ended in the subcutaneous area with an abscess joint without continuous solution with the skin. A laparotomic surgical procedure was successfully performed. Histopathology confirmed the surgical suspect of utero-cutaneous fistula.Although utero-cutaneous fistula is an extremely rare complication, it should be considered if after caesarean section delivery signs and symptoms of skin inflammation and/or infection persist.

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Laparoscopic Management of Post-Cesarean Section Uterocutaneous Fistula

Cited by 11 publications

References 0 publications

Medical management of small uterocutaneous fistulae with gonadotrophin releasing hormone analogs: Case report and literature review

Medical management of small uterocutaneous fistulae with gonadotrophin releasing hormone analogs: Case report and literature review

Uterocutaneous fistula after abdominal myomectomy: A case report

Utero-cutaneous fistula after caesarean section delivery: diagnosis and management of a rare complication

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