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Post surgical ureterovaginal fistula

Case contributed by Sangeet Bhalla
Diagnosis almost certain

Presentation

Patient complaining of clear urine like discharge per vaginum.

Patient Data

Age: 55 years
Gender: Female

Prone axial excretory phase

ct

Axial supine CT images reveal that the right ureter in close proximity with vaginal vault region with vagina cavity opacifying with excretory contrast from the right ureter.

Delayed prone images show right ureter is in close contact with the vaginal vault region and vaginal cavity is filled with contrast from the right ureter.

3D reformatted

ct

3D images show right ureter entering the vaginal vault with excretory contrast in the vaginal cavity.

Case Discussion

Fistulous communication between ureter at the level of pelvic brim/pelvis is a known surgical complication of pelvic surgery namely hysterectomy with salpingo-oophorectomy.

The above patient is a follow up case of hysterectomy with salpingo-oophorectomy for ovarian malignancy. The patient was taken up for surgery and the right ureter was reimplanted into the dome of the urinary bladder.

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