A Case of Vesicouterine Fistula: Unwanted Medical Anomaly but Consequentiality of Most-Wanted Medical Intervention 'Caesarean Section'

Vesicouterine fistula is a rare entity, with unique presentation of cyclical haematuria, amenorrhoea, absence of urinary incontinence (Youssef syndrome). A 35 year old female patient, P2L2 with 2 previous LSCS presented with cyclical haematuria, amenorrhoea, repeated UTI, dating from 11th day of last LSCS. Transabdominal sonography revealed communication between bladder & uterus, confirmed by cystoscopy. At laparotomy fistulous tract delineated and bladder separated from uterus. Hysterectomy and closure of bladder done. Continuous bladder drainage with suprapubic and perurethral foleys catheters maintained. Postoperative period was uneventful. Cystoscopy during followup revealed healthy scar. Vesicouterine fistula is an avoidable complication of LSCS which can be prevented by sound surgical technique.