Intravesical contrast-enhanced ultrasound (CEUS) for the diagnosis of vesicouterine fistula (VUF)

Background: Vesicouterine fistula (VUF) is a very rare type of urogenital fistula, the incidence of which has increased in recent years due to increased cesarean section deliveries and other pelvic surgeries. The clinical diagnosis of VUF is typically challenging. Case: A 31-year-old woman who presented with fever, increase urine frequency, and urinary incontinence at night, along with occasional vaginal discharge after cesarean section. The VUF was misdiagnosed on conventional ultrasound, but was successfully diagnosed by using intravesical contrast-enhanced ultrasound (CEUS) using SonoVue, which was confirmed by the subsequent cystoscopy. Conclusion: Intravesical CEUS provides a new effective method for diagnosing VUF, which may become the first choice for diagnosing urogenital fistulas.