Rodolfo Milani1, Alice Cola1, Matteo Frigerio1, Stefano Manodoro2. 1. Department of Obstetrics and Gynaecology, San Gerardo Hospital, University of Milano-Bicocca, Via Pergolesi 33, Monza, MB, Italy. 2. Department of Obstetrics and Gynaecology, San Gerardo Hospital, University of Milano-Bicocca, Via Pergolesi 33, Monza, MB, Italy. stefano.manodoro@gmail.com.
Abstract
INTRODUCTION AND HYPOTHESIS: Vesicouterine fistula is a rare complication of cesarean section. The aim of this video is to present a case report and to provide a tutorial on the surgical technique of delayed transvaginal repair of a high vesicouterine fistula that developed after cesarean section with manual removal of a morbidly adherent placenta. METHODS: A 43-year-old woman was referred to our unit for continuous urinary leakage 3 months after undergoing a cesarean section with manual removal of a morbidly adherent placenta. A vesicouterine fistula starting from the posterior bladder wall was identified. The surgical repair consisted of a transvaginal layered repair as shown in the video. RESULTS: No surgical complications were observed postoperatively. Two months after surgery the fistula had not recurred and the patient reported no urinary leakage. CONCLUSIONS: Transvaginal layered primary repair of vesicouterine fistula was shown to be a safe and effective procedure for restoring continence. The vaginal route can be particularly attractive for urogynecological surgeons.
INTRODUCTION AND HYPOTHESIS: Vesicouterine fistula is a rare complication of cesarean section. The aim of this video is to present a case report and to provide a tutorial on the surgical technique of delayed transvaginal repair of a high vesicouterine fistula that developed after cesarean section with manual removal of a morbidly adherent placenta. METHODS: A 43-year-old woman was referred to our unit for continuous urinary leakage 3 months after undergoing a cesarean section with manual removal of a morbidly adherent placenta. A vesicouterine fistula starting from the posterior bladder wall was identified. The surgical repair consisted of a transvaginal layered repair as shown in the video. RESULTS: No surgical complications were observed postoperatively. Two months after surgery the fistula had not recurred and the patient reported no urinary leakage. CONCLUSIONS: Transvaginal layered primary repair of vesicouterine fistula was shown to be a safe and effective procedure for restoring continence. The vaginal route can be particularly attractive for urogynecological surgeons.
Authors: Mohamed E Abou-El-Ghar; Ahmed M El-Assmy; Huda F Refaie; Tarek A El-Diasty Journal: J Magn Reson Imaging Date: 2012-04-25 Impact factor: 4.813