A rare presentation of post caesarean vesicouterine fistula

Abstract

A 35 years old woman with history of LSCS 10 days ago, came with dribbling of urine and haematuria. Clinical examination revealed dribbling of urine from the vagina. She was referred to department of radio diagnosis . Ultrasonography and MRI were performed. Ultrasonography revealed a fistulous communication between endometrial cavity and urinary bladder at the level of lower uterine segment. MRI confirmed the findings. Laboratory investigations revealed decreased Hb level (10 mg/ml) but rest of the blood investigations are within normal limit. Urine examination shows few pus cells. After the patient was diagnosed, she was advised surgical repair but patient refused and was discharged against medical advice. Vesicouterine fistulas represent no more than 4% of all urogenital fistulas The case is being reported due to its rarity.