Vesicouterine fistulae as complications of repeated cesarean section

Furbetta, A; Fagioli, Alessio; Cristini, C.; Michetti, Paolo; Trucchi, Alberto; Signore, Sara Del; Vahedi, Mohammad

doi:10.1007/bf00460318

Cited by 16 publications

(7 citation statements)

References 14 publications

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“…The incidence of bladder injury at a repeat operation has been found to be two to three times higher than at the first cesarean section [3,4]. A series of 5 vesicouterine fistulas after repeat procedures has been reported [5]. We now present a patient with urinary symptoms, but no fistula, after repeat cesarean section.…”

Section: Introductionmentioning

confidence: 77%

Dysuria due to Bladder Distortion after Repeat Cesarean Section

Jóźwik¹,

Jóźwik²,

Lotocki³

et al. 1998

Gynecol Obstet Invest

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Section: Introductionmentioning

confidence: 77%

Dysuria due to Bladder Distortion after Repeat Cesarean Section

Jóźwik¹,

Jóźwik²,

Lotocki³

et al. 1998

Gynecol Obstet Invest

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“…In the failed vaginal case, resorting to O'Connor technique with omental interposition was successful, while in the abdominal case, the fistula was rendered much smaller and was repaired vaginally without grafting. Four (9%) cases had a vesicouterine fistula after a repeat cesarean section (range 2-5, mean 3.25), and their symptoms included urinary incontinence solely in three cases and in conjunction with menouria in one case, denoting that these fistulae were isthmic or postisthmic [45][46][47][48][49][50]. All were repaired successfully based on the principles of O'Connor technique, with omental interposition and uterine preservation in two patients and hysterectomy in the other two as they completed their families.…”

Section: Resultsmentioning

confidence: 99%

Urogenital fistulae: changing trends and personal experience of 46 cases

El-Lamie

2007

Int Urogynecol J

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A retrospective study of 46 patients with different types of urogenital fistulae treated by the author during the period from January 1997 to December 2006 is presented. Twenty-two (48%) cases had a vesicovaginal fistula of which 16 (73%) were repaired vaginally and 6 (27%) were repaired abdominally. The remaining fistulae were as follows: 14 (30%) unilateral ureterovaginal fistulae, 6 (13%) ureterovesicovaginal fistulae (one bilateral), and 4 (9%) vesicouterine fistulae. All were repaired abdominally except for one patient with ureterovesicovaginal fistula needing continent urinary diversion using Mainz type II pouch. All fistulae were iatrogenic except one case (2%) which was due to neglected obstructed labor. The iatrogenic causes were gynecologically related in 26 (57%) patients and obstetrically related in 19 (41%) cases. There were two (9%) failed repairs in the vesicovaginal cases, one in each group, and both were salvaged by a secondary surgery. In view of this selected retrospective study and in association with other reports, it seems that with the improvement in the basic health-care services in Egypt, there is a change in the etiology of urogenital fistulae with the vast majority being physician related and no more related to neglected obstructed labor. Such shortcoming should be addressed in the current gynecological surgery training and residency programs.

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“…Prolonged obstructed labor can lead to ischemia, necrosis followed by fistula formation in between the uterine cavity and the bladder. Repeated cesarean sections also result in progressive devascularization of the bladder wall increasing the risk of fistula formation [11] .…”

Section: Discussionmentioning

confidence: 99%

“…Management options for these fistulae vary from prolonged catheter drainage [7] to hormonal manipulation [8,9] and open surgical and laparoscopic repairs [10][11][12][13][14] . The transabdominal approach is the only way to repair VUF, as it cannot be accessed vaginally.…”

Section: Introductionmentioning

confidence: 99%

Robotic Repair of Complex Vesicouterine Fistula with and without Hysterectomy

Hemal

Sharma²,

Mukherjee³

2009

Urol Int

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Objective: To present robotic repair of vesicouterine fistulae (VUF) with and without hysterectomy in 3 cases and to discuss the technique with its outcome. Methods: Three patients were diagnosed with VUF, of whom 2 had a prior history of multiple cesarean sections and 1 had obstructed labor. Preoperative diagnosis of VUF was based on classic history, cystoscopy and imaging studies. All patients underwent pure robotic repair of VUF with hysterectomy in 1 case. The steps of the technique are cystoscopy, bilateral ureteral catheterization, port placement, adhesiolysis, separation of bladder and uterus and excision of the VUF with freshening of margins, closure of the uterus and bladder, hysterectomy in 1 case, and omental interposition. Results: Robotic repair of VUF was successful in all cases with mean operative time of 127.5 min and average blood loss of 120 ml. One patient underwent simultaneous robotic hysterectomy. All patients were ambulatory on day 1 and were discharged on day 3 with indwelling Foley’s catheter, which was removed on day 10. Conclusion: Robotic repair of VUF is safe and effective with successful outcome in all cases and has all the advantages of open and laparoscopic surgery. If required, concomitant robotic hysterectomy can also be performed. This is the first case series in the world.

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Vesicouterine fistulae as complications of repeated cesarean section

Cited by 16 publications

References 14 publications

Dysuria due to Bladder Distortion after Repeat Cesarean Section

Dysuria due to Bladder Distortion after Repeat Cesarean Section

Urogenital fistulae: changing trends and personal experience of 46 cases

Robotic Repair of Complex Vesicouterine Fistula with and without Hysterectomy

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