Cystoscopic fistulography: a new technique for the diagnosis of vesicocervical fistula.
BACKGROUND
Most fistulas communicating with the bladder are large enough to be diagnosed easily, or small enough to close spontaneously without clinical sequel. A vesicocervical fistula is an uncommon event and may be difficult to diagnose.


METHODS
During an operative cystourethroscopy procedure, suspicious areas of the bladder can be probed with a cone tip catheter and injected with contrast dye to visualize the suspected fistula communicating with the bladder.


RESULTS
This technique was employed when a double dye test, an intravenous urogram, a cystogram, a computed tomography scan, and a hysterogram failed to localize the fistulous tract in a patient who was 3 weeks postpartum after a repeat cesarean with complaint of persistent urinary incontinence.


CONCLUSIONS
Cystoscopic catheterization of suspicious lesions in the bladder may visualize an otherwise elusive fistulous tract.
Shobeiri
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SA
Department of Obstetrics and Gynecology, Section of Female Pelvic Medicine and Reconstructive Surgery, Louisiana State University Health Sciences Center, New Orleans, Louisiana, USA. ashobe@lsuhsc.edu
Chesson
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RR
Echols
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KT
D000328:Adult; D002404:Catheterization; D004396:Coloring Agents; D003558:Cystoscopy / Q000379:methods*; D005260:Female; D006801:Humans; D049590:Postpartum Period; D011247:Pregnancy; D011859:Radiography; D001747:Urinary Bladder Fistula / Q000175:diagnosis* / Q000000981:diagnostic imaging; D002577:Uterine Cervical Diseases / Q000175:diagnosis* / Q000000981:diagnostic imaging
D004396:Coloring Agents