title: [Vaginal repair of a vesico-uterine fistula type I (Jozwik) after caesarean section].
abstract: 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.
authors.affiliation: Klinik und Poliklinik für Frauenheilkunde und Geburtshilfe der Ludwig-Maximilians-Universität München -- Innenstadt.
authors.forename: K
authors.initials: K
authors.lastname: Jundt
authors.forename: A
authors.initials: A
authors.lastname: Gauruder-Burmester
authors.forename: B
authors.initials: B
authors.lastname: Wildt
authors.forename: R
authors.initials: R
authors.lastname: Tunn
mesh_terms: 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*
vernacular_title: Transvaginaler Verschluss einer nach Re-Sectio caesarea aufgetretenen vesico-uterinen Fistel Typ I (Jozwik).