International Urogynecology Journal

, Volume 29, Issue 2, pp 309–311 | Cite as

Repair of a vesicouterine fistula following cesarean section

  • Rodolfo Milani
  • Alice Cola
  • Matteo Frigerio
  • Stefano ManodoroEmail author
IUJ Video


Introduction and hypothesis

Vesicouterine fistula is a rare complication of cesarean section. The aim of this video is to present a case report and to provide a tutorial on the surgical technique of delayed transvaginal repair of a high vesicouterine fistula that developed after cesarean section with manual removal of a morbidly adherent placenta.


A 43-year-old woman was referred to our unit for continuous urinary leakage 3 months after undergoing a cesarean section with manual removal of a morbidly adherent placenta. A vesicouterine fistula starting from the posterior bladder wall was identified. The surgical repair consisted of a transvaginal layered repair as shown in the video.


No surgical complications were observed postoperatively. Two months after surgery the fistula had not recurred and the patient reported no urinary leakage.


Transvaginal layered primary repair of vesicouterine fistula was shown to be a safe and effective procedure for restoring continence. The vaginal route can be particularly attractive for urogynecological surgeons.


Vesicouterine fistula Vaginal route Layered repair Complication 


Compliance with ethical standards

Conflicts of interest



Written informed consent was obtained from the patient for publication of this video case report and any accompanying images.

Supplementary material


(MP4 96921 kb)


  1. 1.
    Lenkovsky Z, Pode D, Shapiro A, Caine M. Vesicouterine fistula: a rare complication of cesarean section. J Urol. 1988;139:123–5.CrossRefGoogle Scholar
  2. 2.
    Alkatib M, Franco AV, Fynes MM. Vesicouterine fistula following cesarean delivery: ultrasound diagnosis and surgical management. Ultrasound Obstet Gynecol. 2005;26:183–5.CrossRefGoogle Scholar
  3. 3.
    Kilinc F, Bagis T, Guvel S, Egilmez T, Ozkardes H. Unusual case of post-cesarean vesicouterine fistula (Youssef’s syndrome). Int J Urol. 2003;10(4):236–8.CrossRefGoogle Scholar
  4. 4.
    Abou-El-Ghar ME, El-Assmy AM, Refaie HF, El-Diasty TA. Radiological diagnosis of vesicouterine fistula: role of magnetic resonance imaging. J Magn Reson Imaging. 2012;36(2):438–42. Scholar
  5. 5.
    Porcaro AB, Zicari M, Zecchini Antoniolli S, Pianon R, Monaco C, Migliorini F, et al. Vesicouterine fistulas following cesarean section: report on a case, review and update of the literature. Int Urol Nephrol. 2002;34(3):335–44.CrossRefGoogle Scholar
  6. 6.
    Ramalingam M, Senthil K, Pai M, Renukadevi R. Laparoscopic repair of vesicouterine fistula – a case report. Int Urogynecol J Pelvic Floor Dysfunct. 2008;19:731–3.CrossRefGoogle Scholar
  7. 7.
    Bettez M, Breault G, Carr L, Tu LM. Early versus delayed repair of vesicouterine fistula. Can Urol Assoc J. 2011;5(4):E52–5.CrossRefGoogle Scholar

Copyright information

© The International Urogynecological Association 2017

Authors and Affiliations

  1. 1.Department of Obstetrics and Gynaecology, San Gerardo HospitalUniversity of Milano-BicoccaMonzaItaly

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