Surgical treatment of a vesico-uterine fistula after cesarean section

封面

如何引用文章

全文:

开放存取 开放存取
受限制的访问 ##reader.subscriptionAccessGranted##
受限制的访问 订阅或者付费存取

详细

Relevance: The article discusses the diagnosis and surgical treatment of a complex obstetric complication, namely vesico-uterine fistula after cesarean section (Youssef’s syndrome), with a minimally invasive access and modern medical technologies. Vesico-uterine fistula is usually a complication of surgical delivery or pathological delivery and it accounts for up to 9% of all urogynecological fistulas. The article presents the analysis of modern literature on genitourinary fistulas and a clinical observation of a vesico-uterine fistula in a 38-year-old patient.

Case report: The patient presented with hypomenorrhea and cyclic discharge of urine with blood during menstruation, periodic pain in the lower abdomen. In addition to standard visual diagnostic techniques, such as ultrasound and MRI, an office cystoscopy was performed to diagnose a fistula. The vesico-uterine fistula was sutured using laparoscopic access, with simultaneous metroplasty performed using fibrin glue. The long-term results of the operation were assessed after 4 months; the patient had no problems with urination; the thickness of the myometrium in the metroplasty area was 4 mm.

Conclusion: In order to prevent the development of a vesico-uterine fistula during cesarean section, it is necessary to perform the bladder mobilization. The vesico-uterine fistula should be sutured by a multidisciplinary surgical team with the participation of a urologist.

全文:

受限制的访问

作者简介

А. Kozachenko

Academician V.I. Kulakov National Medical Research Centre for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia

编辑信件的主要联系方式.
Email: a_kozachenko@oparina4.ru
ORCID iD: 0000-0002-5573-6694

Dr. Med. Sci., Senior Researcher at the Gynecological Department

俄罗斯联邦, Moscow

T. Shatylko

Academician V.I. Kulakov National Medical Research Centre for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia

Email: t_shatylko@oparina4.ru
ORCID iD: 0000-0002-3902-9236

PhD, urologist at the Andrology and Urology Department

俄罗斯联邦, Moscow

A. Dzhabiev

Academician V.I. Kulakov National Medical Research Centre for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia

Email: a_dzhabiev@oparina4.ru
ORCID iD: 0000-0002-2858-0129

PhD, doctor at the Ultrasound and Functional Diagnostics Department

俄罗斯联邦, Moscow

E. Latfullina

Academician V.I. Kulakov National Medical Research Centre for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia

Email: latfullinaelina@mail.ru
ORCID iD: 0009-0004-6586-7788

resident physician

俄罗斯联邦, Moscow

参考

  1. Caraman R., Toma A., Balescu I., Stiru O., Savu C., Diaconu C. et al. Vesico-uterine fistula following c-section – a case report and literature review. In Vivo. 2022; 36(1): 528-32. https://dx.doi.org/10.21873/ invivo.12734
  2. Richter L.A., Lee H., Nishimwe A., Niteka L.C., Kielb S.J. et al. Characteristics of genitourinary fistula in Kigali, Rwanda; 5-year trends. Urology. 2021; 150: 165-9. https://dx.doi.org/10.1016/j.urology.2020.05.077
  3. Holme A., Breen M., MacArthur C. Obstetric fistulae: a study of women managed at the Monze Mission Hospital, Zambia. BJOG. 2007; 114(8): 1010-7. https://dx.doi.org/10.1111/j.1471-0528.2007.01353.x
  4. Rasekhjahromi A., Chitrani Z., Khlili A., Babaarabi Z.Z. Complications associated with intravesical migration of an intrauterine device. Obstet. Gynecol. Sci. 2020; 63(5): 675-8. https://dx.doi.org/10.5468/ogs.19105
  5. Briceno S.A., Brown M.R., Herson A.B., Fischer S.T., Healey K.D., Miller B.T. et al. Long-term retained lippes loop intrauterine device causes vesicouterine fistula. Cureus. 2023; 15(4): e38217. https://dx.doi.org/10.7759/ cureus.38217
  6. Paluku J.L., Furaha C.M., Bartels S.A., Aksanti B.K., Kataliko B.K., Kasereka J.M. et al. Obstetric vesico-uterine fistula in nine reference hospitals in the Democratic Republic of the Congo: epidemiological, clinical, and therapeutic aspects. BMC Women’s Health. 2024; 24(1): 309. https:// dx.doi.org/10.1186/s12905-024-03124-w
  7. Yin S., Chen L., Zhou Y., Yuan P., Guo X. , Lu J. et al. Evaluation of cesarean rates for term, singleton, live vertex deliveries in China in 2020 among women with no prior cesarean delivery. JAMA Netw. Open. 2023; 6(3): e234521. https:// dx.doi.org/10.1001/jamanetworkopen.2023.4521
  8. Cavoretto P.I., Candiani M., Farina A. Cesarean delivery uptake trends associated with patient features and threshold for labor anomalies. JAMA Netw. Open. 2023; 6(3): e235436. https://dx.doi.org/10.1001/jamanetworkopen.2023.5436
  9. Rydahl E., Declercq E., Juhl M., Maimburg R.D. Cesarean section on a rise-does advanced maternal age explain the increase? A population register-based study. PLOS One. 2019; 14(1): e0210655. https://dx.doi.org/10.1371/ journal.pone.0210655
  10. Bonavina G., Busnelli A., Acerboni S., Martini A., Candiani M., Bulfoni A. et al. Surgical repair of post-cesarean vesicouterine fistula: a systematic review and a plea for prevention. Int. J. Gynaecol. Obstet. 2024; 165(3): 894-915. https://dx.doi.org/10.1002/ijgo.15256
  11. Byamukama O., Tarnay C., Ainomugisha B., Tibaijuka L., Kajabwangu R., Kalyebara P.K. et al. Iatrogenic female genitourinary fistula in Uganda: etiology, twelve-year trends, and risk factors for development following cesarean section. Int. J. Womens Health. 2024; 16: 1865-73. https://dx.doi.org/10.2147/ IJWH.S473024.
  12. Mishra V., Pandey H., Shekhar S., Sharma C. Incidentally diagnosed type 2 Youssef's syndrome with migrated postcesarean postpartum intrauterine contraceptive device. Gynecol. Minim. Invasive Ther. 2022; 11(1): 67-9. https://dx.doi.org/10.41.03/GMIT.GMIT_107_20
  13. Yan Z.P., Wang C.C., Wang Y.Y., Zhao S.T. A case with type II vesicouterine fistula. Clin. Case Rep. 2022; 10(2): e05284. https://dx.doi.org/10.1002/ccr3.5284
  14. Rahmita M.M., Rodjani A., Wahyudi I., Widia F. Rare cases of vesicouterine fistula. Low Urin. Tract Symptoms. 2022; 14(5): 401-4. https:// dx.doi.org/10.1111/luts.12440
  15. Govorov I.E., Vorobeva M.A., Komlichenko E.V. Robotic repair of the symptomatic vesicouterine fistula. Int. Urogynecol. J. 2021; 32(7): 1945-7. https:// dx.doi.org/10.1007/s00192-020-04558-0
  16. Kettache R., Merad A., Buchholz N.N.P. Surgical management of Youssef's syndrome: a case report. Urol. Int. 2020; 104(9-10): 833-6. https:// dx.doi.org/10.1159/000509205
  17. Diaouga H.S., Yacouba M.C., Garba R.M., Salifou I., Manzo M.S.O., Nayama M. Youssef’s syndrome, a rare complication of caesarean section: a case report. Int. J. Surg. Case Rep. 2024; 117: 109517. https://dx.doi.org/10.1016/ j.ijscr.2024.109517

补充文件

附件文件
动作
1. JATS XML
下载
2. Fig. 1. Ultrasound of the pelvic organs in 3D mode. A fistula tract is determined between the bladder and the uterine cavity with locally thickened mucous membrane

下载 (267KB)
索引源数据
3. Fig. 2. Ultrasound of the bladder. Thickening of the mucous membrane of the posterior wall of the bladder in the area of the fistula defect up to 6.6 mm is noted.

下载 (325KB)
索引源数据
4. Fig. 3. Ultrasound of the pelvic organs in 4D mode. A star-shaped fistula defect with retractions of the bladder mucosa into the fistula tract is determined.

下载 (350KB)
索引源数据
5. Fig. 4. MRI of the pelvic organs: the first image in the sagittal plane T2-weighted image shows retraction from the serous membrane in the area of the vesicouterine space, cicatricial changes; the second image in the coronal plane T2-weighted image shows a defect in the anterior wall of the uterus with retraction of the wall of the urinary bladder, more on the left

下载 (601KB)
索引源数据

版权所有 © Bionika Media, 2025