Case Reports SPONTANEOUS CLOSURE OF VESICOUTERINE FISTULA: A CASE REPORT

Abstract

Vesicouterine fistula is a rare variety of urogenital fistula, representing about 1-4% of all cases, and caesarean section is the most common cause. The clinical presentation is variable and mainly includes a triad of cyclical hematuria (memoria), amenorrhoea, and urinary continence termed as Youssef's syndrome. The mainstay of treatment is surgical excision, and only less than 5% of patients respond to conservative therapy. Laparoscopic and robotic-assisted surgery is also gaining popularity. The case reported here was a young multiparous woman with previous four lower segment caesarean sections and had her elective fifth caesarean section and bilateral tubal ligation. The bladder was high up and badly adherent to the previous scar. She developed hematuria in the immediate postoperative period. Retrograde cystography confirmed the diagnosis of small vesicouterine fistula. The Patient responded to conservative management by catheterization for six weeks. Healing of fistula confirmed by repeat cystogram, and the Patient is having normal menstruation with no urinary problem