VESICO-UTERINE FISTULA FOLLOWING A CAESAREAN SECTION: A CASE STUDY.

Abstract

Background:

Vesico-uterine fistula refers to abnormal communication between the urinary bladder and the uterine cavity. It’s among the obstetric fistulas which occur as part of the complications of medico-surgical procedures such as post-caesarian sections, and post-irradiation as in cancer treatment among others. About two million women worldwide have genital fistula with an annual incidence of 50,000 to 100,000 cases. In sub-Saharan Africa. an estimated 33,000 new fistula cases occur each year. 

Case presentation: 

This case study was of a 34-year-old female who came into the hospital complaining of long-standing abdominal pains associated with constant vaginal watery discharge, menstrual irregularities, painful sexual intercourse, and on-and-off urinary incontinence. All these started after a caesarian section was done one year ago. Her past Obstetric history revealed that she had ever had two vaginal deliveries and 1 caesarian section a year ago. 

Results:

On ultrasonography, it was revealed that there was a defect in the continuity of the anterior wall of the uterus making a connection between the endometrial cavity and the urinary bladder. This was in line with the definition of a vesicouterine fistula.

Conclusion: 

The report concluded that vesicouterine fistula is one of the genital urinary fistulae that can occur following a caesarian section and with increasing trends directly proportional to an increase in the incidence of caesarian sections.

Recommended:

That every mother who has had a caesarian section should do a post-natal ultrasound at least within the first 6 months following the operation. This will help to identify potential genito-urinary fistulas earlier enough which can improve their overall management.