title: Uretero-vesico-cervical fistula following a caesarean section: a unique case report.
abstract: A unique combined fistula involving simultaneously the bladder, ureter, and cervix following cesarean section is described. Evaluation, management, and review of the literature regarding this rare and challenging case are reported. This unique case report emphasizes the potential complexity of iatrogenic genitourinary fistulae, suggesting that these might have unexpected morphology and present with multiple fistulous components. It has been demonstrated that concomitant ureteral involvement is estimated to complicate at least 10 % of vesico-vaginal fistulae. Thus, increased awareness of the possibility of complex iatrogenic fistulae and precise evaluation of the upper urinary tract are necessary to accurately define the extent of all fistulous tracts during the initial evaluation. This in turn may enable tailored management of these challenging cases. Moreover, in the case of surgical treatment, an accurate initial definition of fistula morphology may enable a single-stage reconstructive procedure sparing additional interventions and avoiding any potential complications.
authors.affiliation: Department of Urologic Surgery, E. Wolfson Medical Center, Holon, Israel.
authors.forename: Maria
authors.initials: M
authors.lastname: Tsivian
authors.forename: Matvey
authors.initials: M
authors.lastname: Tsivian
authors.forename: A Ami
authors.initials: AA
authors.lastname: Sidi
authors.forename: Alexander
authors.initials: A
authors.lastname: Tsivian
mesh_terms: D000328:Adult; D002585:Cesarean Section / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007049:Iatrogenic Disease; D011247:Pregnancy; D015607:Stents; D016896:Treatment Outcome; D014515:Ureteral Diseases / Q000209:etiology* / Q000601:surgery; D001747:Urinary Bladder Fistula / Q000209:etiology* / Q000601:surgery; D002577:Uterine Cervical Diseases / Q000209:etiology* / Q000601:surgery