Vesico-uterine fistula

Case contributed by Dario Giambelluca
Diagnosis certain

Presentation

History of recent cesarean section. The patient complains of cyclic hematuria (menouria) and discharge of urine through the vagina.

Patient Data

Age: 40 years
Gender: Female
ct

Renal excretory phase CT images show a connection between the superior surface of bladder and the post-gravid uterus, which can be better seen on reformatted sagittal and coronal images. The distal end of urinary catheter is located just below the fistula. Small amount of fluid in pelvis.

Case Discussion

Vesico-uterine fistula is a rare complication of Cesarean section due to a transverse incision into the lower segment. The symptoms are menouria and urinary incontinence.

Excretory phase CT images show a fistulous tract between the uterus and bladder, indicating a vesico-uterine fistula.

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