[Vaginal repair of a vesico-uterine fistula type I (Jozwik) after caesarean section].
The development of a vesico-uterine fistula is a problem which occurs with an increasing number of caesarean sections. The main symptoms are permanent urinary incontinence, cyclic hematuria ("menouria") and amenorrhoea. In only 5 % of cases, spontaneous closure with bladder catheterization over weeks and hormonal management is possible, most of the time a surgical procedure is the definitive treatment. Until now, the resection of this kind of fistula was performed using a transabdominal approach most of the time. Our procedure describes a surgical repair using a transvaginal approach by exciding the fistula out of the bladder and uterus with primary closure. In this way, a recurrent laparotomy with all known associated risks could be avoided. However, after definitive treatment of the fistula, a new pregnancy should be delivered by performing a caesarean section. In this way, a rupture of the uterus during delivery could be prevented.
Jundt
K
K
Klinik und Poliklinik für Frauenheilkunde und Geburtshilfe der Ludwig-Maximilians-Universität München -- Innenstadt.
Gauruder-Burmester
A
A
Wildt
B
B
Tunn
R
R
D000328:Adult; D000568:Amenorrhea / Q000209:etiology; D005260:Female; D005402:Fistula / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D016896:Treatment Outcome; D014463:Ultrasonography; D001745:Urinary Bladder Diseases / Q000000981:diagnostic imaging / Q000601:surgery*; D014549:Urinary Incontinence / Q000209:etiology; D014591:Uterine Diseases / Q000000981:diagnostic imaging / Q000601:surgery*
Transvaginaler Verschluss einer nach Re-Sectio caesarea aufgetretenen vesico-uterinen Fistel Typ I (Jozwik).