Transmural vaginal-to-bladder injury from an obstructed labor pattern.
BACKGROUND
A vesicovaginal fistula, among other devastating sequelae, is a complication that can arise from obstetric trauma such as prolonged obstructed labor patterns. These are rarely seen as obstetric-related complications in well-developed countries. They are thought to arise from direct ischemic injury that can occur between the fetal head and the adjacent tissues.


METHODS
A patient presented to the emergency room in obstructed labor. Examination revealed a crowning fetal head, no fetal heart tones, and purulent vaginal discharge. Postpartum, the patient experienced irritative voiding symptoms, vaginal stenosis, and cystoscopic evidence of injury to the bladder base.


CONCLUSIONS
These findings may provide evidence of the transmural vaginal-to-bladder damage that can occur from obstructed labor.
From the Division of Urogynecology, Department of Obstetrics and Gynecology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma; and The Womens Health Group, St John Medical Center, Tulsa, Oklahoma.
Arielle M
AM
Allen
Tracy
T
Lakin
S Abbas
SA
Shobeiri
Mikio
M
Nihira
D058186:Acute Kidney Injury / Q000209:etiology / Q000628:therapy; D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D057785:Catheters; D003556:Cystitis / Q000209:etiology; D004716:Endometritis / Q000188:drug therapy / Q000209:etiology; D005260:Female; D005313:Fetal Death / Q000209:etiology*; D020233:Gait Disorders, Neurologic / Q000209:etiology; D006801:Humans; D007743:Labor, Obstetric; D007744:Obstetric Labor Complications / Q000175:diagnosis*; D011247:Pregnancy; D001743:Urinary Bladder / Q000293:injuries*; D014621:Vagina / Q000293:injuries*; D019522:Vaginal Discharge / Q000188:drug therapy / Q000209:etiology; D014719:Vesicovaginal Fistula / Q000175:diagnosis / Q000209:etiology*
D000900:Anti-Bacterial Agents
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