Uterine Fistula

About: Uterine Fistula is a research topic. Over the lifetime, 131 publications have been published within this topic receiving 931 citations.

Ileo-uterine fistula after dilatation and curettage: Case report

Abstract: Ileo-uterine fistula is a very rare occurrence. In this case we presented a case of ileo-uterine fistula , which developed after dilatation and curettage for termination of pregnancy.The case was managed surgically.

Canine Uterine Rupture with Septic Peritonitis Results from Adenocarcinoma in a 2-year-old Maltese Dog

Abstract: A 2-year-old female Maltese dog was presented with a history of anemia and vaginal hemorrhagic discharge. Physical examination revealed severe vaginal hemorrhagic discharge, abdominal pain, pale mucous membranes, low blood pressure and dehydration. Results of serum biochemistry, hematology, venous blood gas, and electrolyte canine C-reactive protein (CRP) test revealed severe normocytic normochromic anemia, severe neutropenia, a high level of CRP, hypoglycemia, and imbalanced electrolytes. Abdominal ultrasound examination showed focal hypoechoic defect with loss of layering in uterine horn wall. A laparotomy revealed a clear reddish fluid in the abdomen, the fistula of left and right uterine horn, the purulent discharge from fistula, and symptoms of septic peritonitis near by the fistula site. The bitch underwent ovariohysterectomy and recovered without complication. Histopathological diagnosis of the uterine fistula site was adenocarcinoma.

Vesico-Uterine Fistula after TURB in pregnancy, a rare cause of genitourinary fistula.

Abstract: Vesico-uterine fistulas (VUFs) are rare genitourinary fistulas developing, in most cases, secondary to iatrogenic aetiologies such as repeated Caesarean sections (CSs) [1]. In this article, we report the first published case of a VUF after transurethral resection of the bladder (TURB) during pregnancy. A 38-year-old multiparous woman in her seventh pregnancy, having had three previous CSs, presented at the 20th week of gestation with macroscopic haematuria. She had a history of a uterine perforation, which had occurred about 15 years previously caused by an intrauterine device (IUD). The IUD had migrated to the bladder and was removed by laparotomy. After this surgery she had two subsequent pregnancies with delivery at term. At admission the vaginal ultrasound examination showed a normal intrauterine pregnancy and a polypoid tumour in the posterior wall of the urinary bladder. A cystoscopy confirmed the ultrasonography finding. A broad based solid non-specific tumour with calcification was found in the posterior wall of the bladder. The cytology was benign. Two cold biopsies were taken during the cystoscopy and these showed necrosis and calcification. Additionally a TURB was performed in order to exclude malignancy. The patient was admitted to the obstetric department two days later with suspected preterm rupture of the membranes at the 22nd week of gestation. The vaginal ultrasound as well as a new cystoscopy demonstrated the ballooning of the foetal membranes into the urinary bladder through an eight-millimetre defect in the bladder wall (Figure 1). The creatinine level in the watery discharge from the vagina corresponded to that of urine. The histopathology report from the TURB showed urothelial tissue with decidua components and necrosis. A decision was made to treat the patient and the pregnancy conservatively and not to interfere surgically at that time in order to prolong the pregnancy as long as possible. Antibiotic prophylaxis was given with Nitrofurantoin, initially 50mg once daily, increased to 50mg three times daily due to a culture positive for enterococcus faecalis. Serum C-reactive protein was <5mg/L. After one week in-hospital observation at the county hospital she was discharged and followed in the outpatient clinic. At 25 weeks of gestation she was referred to the University Hospital due to a shortening of the cervix to 14mm, preterm premature rupture of membranes and signs of foetal distress. An emergency CS was conducted and a premature girl was delivered. The fistula closure was performed at the same time. The uterus was separated from the bladder and a cystostomy was performed. The bladder and the uterus were sutured with absorbable sutures in one layer and the omentum major was interposed between them (Figure 2). After three weeks, the cystography showed no evidence of leakage and the transurethral catheter was removed. At the clinical control six months after the surgery the patient presented with some problems with dysuria and pain but no signs of urinary incontinence. During the six-month period, urinary tract infection had occurred twice. The mother and the baby were in a good general condition.

Sigmoido-Uterine Fistula Caused by Ovarian Cancer

Abstract: A 67-year-old woman presented with abdominal distension and difficulty in defecation She had a huge mass in the left lower abdomen and hyperamylasemia with normal pancreatic-type amylase (P-AMY) Nuclear magnetic resonance and computed tomography scan revealed a huge pelvic mass, but the origin of mass wasn’t certain After discussion with the multidisciplinary team, ultrasonography guided pathological biopsy of the mass was done Pathological biopsy showed that the mass was poorly differentiated adenocar-cinoma, which may be originated from ovary Patient was on neo-adjuvant chemotherapy After one and a half months of chemotherapy, the patient developed colorectal-reproductive system fistula with hyperpyrexia Laparatomy with resection of mass, sigmoid colon, left ovary and part of uterus, proximal colostomy with closure of the distal rectum and end to end anastomosis of left ureter with DJ tube drainage (left ureter invaded by tumor confirmed intra operation) was done Operative finding: Fistula between sigmoid colon and uterus through the tumor