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. 2020 Sep;46(5):398-402.
doi: 10.5152/tud.2020.20170. Epub 2020 Jul 30.

Endoscopic repair of a vesicouterine fistula with the injection of microfragmented autologous adipose tissue (Lipogems®)

Matteo Giulio Spinelli  1 , Vito Lorusso  2   3 , Franco Palmisano  4 , Michele Morelli  2   3 , Paolo Guido Dell'Orto  1 , Carlo Tremolada  5 , Emanuele Montanari  1   3
Affiliations

Endoscopic repair of a vesicouterine fistula with the injection of microfragmented autologous adipose tissue (Lipogems®)

Matteo Giulio Spinelli et al. Turk J Urol. 2020 Sep.

Abstract

Vesicouterine fistula (VUF) is a rare extra-anatomical communication developing between the uterus or cervix and the urinary bladder, most commonly after an iatrogenic injury during a cesarean section. Patients with VUF may have various clinical presentations, ranging from Youssef's syndrome (vaginal urine leakage, amenorrhea, and menouria) to urinary tract infection and infertility. Quality of life for patients having this pathology is strongly affected owing to the psychological burden. Treatment is surgery based because low success rates have been reported for conservative or minimally invasive approaches. Herein, we present a case of a 35-year-old woman successfully treated by a minimally invasive endoscopic repair procedure with the injection of microfragmented autologous adipose tissue (Lipogems®).

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Conflict of interest statement

Conflict of Interest: The authors have no conflicts of interest to declare.

Figures

Figure 1. a–d
Figure 1. a–d
Diagnostic work-up before treatment: (a) cystogram; (b) cystoscopy; (c) abdominal computed tomography scan; (d) magnetic resonance imaging showing the presence of a vesicouterine fistula
Figure 2. a–f
Figure 2. a–f
Steps of the procedure: (a) anesthesia of the thighs; (b) harvesting of the adipose tissue; (c) collection of the harvested tissue; (d) processing the tissue with Lipogems® surgery kit; (e) transurethral resection of the bladder side of the fistula; (f) injection of microfragmented adipose tissue around the bladder side of the fistula
Figure 3. a, b
Figure 3. a, b
Cystogram (a) and cystoscopy after treatment (b)
See this image and copyright information in PMC

References

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