Herein we report on 1 more case of vesicouterine fistula followingcesarean section with review and update of the literature concerningthis unusual topic. The disease presented with vaginal urinary leakage,cyclic hematuria and amenorrhea. The fistula was successfully repairedby delayed surgery. Actually, all over the world the prevalence of thedisease is increasing for the frequent use of the cesarean section.Fistulas may develop immediately after a cesarean section, manifest inthe late puerperium or occur after repeated procedures. Spontaneoushealing is reported in 5% of cases. Vesicouterine fistulaspresent with vaginal urinary leakage, cyclic hematuira (menouria),amenorrhea, infertility, and first trimester abortions. The diagnosis isruled out by showing the fistulous track between bladder and uterus aswell as by excluding other more frequent urogenital fistulas. Thedisease treatment options include conservative treatment as well assurgical repair. Rarely, patients refuse any kind of treatment becauseof the benignity of symptoms and prognosis of the disease. Conservativemanagement by bladder catheterization for at least 4–8 weeks isindicated when the fistula is discovered just after delivery since thereis good chance for spontaneous closure of the fistulous track. Hormonalmanagement should be tried in women presenting with Youssef's syndrome.Surgery is the maninstay and definitive treatment of vesicouterinefistulas after cesarean section. Patients scheduled for surgery shouldundergo pretreatment of urinary tract infections. Surgical repair ofvesico-uterine fistulas are performed by different approaches whichinclude the vaginal, transvesical-retroperitoneal and transperitonealaccess which is considered the most effective with the lowest relapserate. Recently, laparoscopy has been proposed as a valid option forrepairing vesicouterine fistulas. The endoscopic treatment may beeffective in treating small vesicouterine fistulas. The pregnancy rateafter repair is 31.25% with a rate of term deliveries of25%. The disease may be prevented by emptying the bladder as wellas by carefully dissecting the lower uterine segment. It is advisablethat after vesicouterine fistula repair delivery should be performed byrepeating a cesarean section since the risk of fistula recurrence.Usually, vesicouterine fistulas are diagnosed postoperatively. As aresult, at least 95% of patients will undergo another operationfor repairing the fistula. In the meantime they are bothered by relatedsymptoms which impair their quality of life. As far as we are concernedintraoperative diagnosis is the gold standard in detecting vesicouterinefistulas for allowing immediate repair. We propose intraoperativesonography by the transvaginal (or transrectal) route for the Foleytransurethral catheter producing bloody urine, for suspecting bladderinjury while dissecting the uterine lower segment and for monitoringpatients who already had had vesicouterine fistula repair. As a resultpatients will avoid the familial and social problems related to thedisease as well another operation. Moreover, ultrasound Dopplerexamination may help in better investigating and understanding thepathophysiology of vesicouterine fistulas.

Vesicouterine fistulas following cesarean section: report on a case, review and update of the literature.

Few specialties have a longer or richer eponymous background than obstetrics and gynaecology. Eponyms add a human side to an increasingly technical profession and represent the historic tradition and language of the speciality. This collection aims to perpetuate the names and contributions of pioneers and offer introductory profiles to the founders in whose steps we follow. This third edition includes 26 new entries, as well as expanded detail, illustration and quotation for existing entries. Biographical data and historical and medical context are discussed for each of the 391 names, with reference to 34 countries, reflecting the field's far reaching origins. More than 1700 original references feature, alongside an extensive bibliography of more than 2500 linked references to assist readers searching for more detailed information. This is a volume for physicians, midwives, medical historians, medical ethicists and all those interested in the history and evolution of obstetrical and gynaecological treatment.

Eponyms and Names in Obstetrics and Gynaecology

A handful of traditional and newer therapeutic procedures, such as chemotherapy, immunotherapy, radiotherapy, photodynamic and laser treatment, and gene therapy, are used to treat epithelial malignancies of bladder origin. These treatment modalities, used either intravesically or systemically, produce morphological changes in the urothelial mucosa that can be mistaken for carcinoma. The pathologist must be able to separate toxic and drug related alterations from tumour related changes. The clinical history is usually invaluable in this assessment.

https://jcp.bmj.com/content/jclinpath/55/9/641.full.pdf

Changes produced in the urothelium by traditional and newer therapeutic procedures for bladder cancer

Clinical classification of vesicouterine fistula

Vesicouterine fistula — an analysis of 24 cases from Poland

Ninety-two cases of vesicouterine fistula reported in the world literature since 1908 are reviewed. The lesion was rarely seen before 1947. It usually followed a vaginal operative delivery and the usual complaint was total urinary incontinence. Diagnosis was most often made indirectly by seeing urin

Tancer Ml

Papers

Vesicouterine fistula--a review.