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Vesicouterine Fistula After Cesarean Delivery at Full Cervical Dilation.
- Source :
-
Urogynecology (Philadelphia, Pa.) [Urogynecology (Phila)] 2023 Dec 01; Vol. 29 (12), pp. 974-979. Date of Electronic Publication: 2023 Jul 29. - Publication Year :
- 2023
-
Abstract
- Importance: Vesicouterine fistula (VUF) is an iatrogenic consequence of cesarean section in the vast majority of cases. The worldwide increase of cesarean delivery rates is likely to be accompanied by a rise of this complication, and surgery is the mainstay treatment.<br />Objective: The aim of the study is to assess current evidence on VUF pathogenesis and management.<br />Study Design: The study is a case report and literature review on PubMed and Embase spanning over the past 2 decades.<br />Results: An early VUF developed after a cesarean section at full cervical dilation and concurrent incidental bladder injury. A transabdominal extravesical repair was performed 3 months after cesarean delivery. Both the cystotomy and hysterotomy were repaired in a double-layer fashion with no interposition flap. A contemporary literature review including 25 patients showed that VUF was repaired transabdominally in 21 patients (84%), and an open approach was adopted in 18 patients (85.7%). In most patients, the uterine side was closed with a single-layer suture and an interposition flap was used to reinforce the repair. Concomitant hysterectomy was performed in 6 patients (24%). Overall, successful term pregnancies were reported in 2 patients after VUF repair.<br />Conclusions: Vesicouterine fistula is a rare event and is commonly associated with cesarean sections, especially those with a concurrent bladder injury. Careful and meticulous surgical technique may prevent the occurrence of this condition. Delayed repair and double-layer closure of both bladder and uterus, with or without an interposition flap, are recommended.<br />Competing Interests: The authors have declared they have no conflicts of interest.<br /> (Copyright © 2023 American Urogynecologic Society. All rights reserved.)
Details
- Language :
- English
- ISSN :
- 2771-1897
- Volume :
- 29
- Issue :
- 12
- Database :
- MEDLINE
- Journal :
- Urogynecology (Philadelphia, Pa.)
- Publication Type :
- Academic Journal
- Accession number :
- 37493274
- Full Text :
- https://doi.org/10.1097/SPV.0000000000001398