Vesicouterine fistulas: imaging findings in three cases.
OBJECTIVE
The objective of our report is to present three cases of vesicouterine fistulas secondary to a cesarean delivery, a uterine rupture during labor, and radiation therapy. The delay between the onset of symptoms and the diagnosis varied between 3 and 7 years. Different techniques such as color Doppler sonography, excretory urography, cystography, CT, MRI, cystoscopy, vaginoscopy, and hysterography were performed with variable results, mostly negative and sometimes undefined.


CONCLUSIONS
The definitive diagnosis was made with contrast-enhanced helical CT after cystography in one case, unenhanced helical CT after hysterography in another case, and cystography in the third case. Vesicouterine fistula rarely is thought of in the differential diagnosis because of its rarity and negative results on radiologic and endoscopic tests. The diagnosis is made on imaging after opacification of the uterus or the bladder depending on the pressure gradient obtained and the location of the fistula in relation to the uterine isthmus.
Smayra
Tarek
T
Department of Radiology, Hôtel-Dieu de France, Blvd. Alfred Naccache, Achrafieh, PO Box 16-6830, Beirut, Lebanon.
Ghossain
Michel A
MA
Buy
Jean-Noël
JN
Moukarzel
Maroun
M
Jacob
Denis
D
Truc
Jean-Bernard
JB
D000328:Adult; D000368:Aged; D002585:Cesarean Section / Q000009:adverse effects; D003287:Contrast Media; D003937:Diagnosis, Differential; D005119:Extravasation of Diagnostic and Therapeutic Materials; D005260:Female; D006801:Humans; D011878:Radiotherapy / Q000009:adverse effects; D014057:Tomography, X-Ray Computed; D001747:Urinary Bladder Fistula / Q000000981:diagnostic imaging* / Q000209:etiology; D014591:Uterine Diseases / Q000000981:diagnostic imaging* / Q000209:etiology; D014597:Uterine Rupture / Q000150:complications
D003287:Contrast Media