Vesico‐uterine fistula: report of 14 cases

TLDR: Authors from Serbia present a retrospective review of their experience in the treatment of the uncommon condition of vesico‐uterine fistula, and present the results of surgery, with advice on how to optimise the results.

Abstract: OBJECTIVE To analyse the indications, diagnosis, major causes and basic principles of surgical treatment of vesico-uterine fistulas (VUF). PATIENTS AND METHODS From 1970 to 2006, 14 patients underwent surgical repair of VUF in two Belgrade hospitals. The most common cause of a fistula was previous Caesarean section (13/14). The mean (range) age was 27 (22-38) years. Five women underwent transvesical fistula suture, and nine underwent a transperitoneal surgical approach with the interposition of a tissue flap; an omental flap in five and a peritoneal flap in four. RESULTS The mean (range) duration of surgery was 85 (70-120) min. The mean hospital stay was 14 (12-22) days. The urethral catheter was removed 10 days after surgery. One woman with no tissue flap repair relapsed and none of the women with a tissue flap repair relapsed. After surgery, eight patients became pregnant and underwent Caesarean section. CONCLUSION Successful closure of VUF requires accurate diagnostic evaluation, appropriate repair using techniques that utilize basic surgical principles, and the careful application of interposing tissue flaps.