Vesicouterine fistula--an analysis of 24 cases from Poland

Abstract

Objective: This study was undertaken to evaluate what clinical events or situations are currently associated with the occurrence of vesicouterine fistula.

Method: A retrospective investigation was carried out on 24 patients treated in a tertiary referral center during a 12-year period. Clinical data were collected from the patients directly, the medical records, urographic and/or cystoscopic findings before repair and intraoperative findings at repair.

Results: All fistulas were iatrogenic, and 21 (87.5%) occurred following cesarean section or cesarean hysterectomy. Bladder injury occurred two times more often after repeat operations than after the primary. The proportion of repeat cesarean section resulting in a fistula was significantly increased (58.3% vs. 29.6%, P < 0.013) when compared to that previously reported.

Conclusions: Cesarean sections are currently the single major risk factor associated with the occurrence of vesicouterine fistulas. Repeat procedures increase the risk of bladder injury and resultant fistulas.