Uretero-vaginal fistula

Case contributed by Dr Ian Bickle

Presentation

Patient attends hospital one most following an elective hysterectomy and BSO, with a contuined feeling of a watery perineal discharge.

Patient Data

Age: 45
Gender: Female
CT

Left duplex collecting system, which unites into a single ureter in the distal third.

A contrast filled structure in keeping with the vaginal vault, posterior the contrast filled urinary bladder, is evident in the pelvis.  A tract extends from the ureter directly into the vaginal vault with contrast entering the posterior aspect of the vault, in keeping with a vagino-ureteric fistula.

Annotated image

Image 1: The RED arrows indicate the site where the ureter fistulates with the vaginal vault.

Image 2: C = catheter    B = bladder  V = vaginal vault ( which contains contrast )

Case Discussion

A beautiful example of the role of CT-IVU in assessing the urinary tract.  The CT-IVU adds anatomical value over and above a traditional IVU or fluroscopic studies.

The fistula between the ureter and vaginal vault if well illustrated, this being a complication of surgery.

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Case information

rID: 25973
Case created: 19th Nov 2013
Last edited: 5th Mar 2016
Tag: fistula
Inclusion in quiz mode: Included

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